Provider Demographics
NPI:1366538886
Name:BEIER, CHARLES G (O D)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:G
Last Name:BEIER
Suffix:
Gender:M
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4816 S.W. WEST HILLS DR.
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-2244
Mailing Address - Country:US
Mailing Address - Phone:785-273-2582
Mailing Address - Fax:
Practice Address - Street 1:2400 S.W. 29TH ST.
Practice Address - Street 2:#136
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66611
Practice Address - Country:US
Practice Address - Phone:785-266-3285
Practice Address - Fax:785-266-3285
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1095-3152W00000X
MO002312152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0000005091OtherBLUE CROSS/BLUE SHIELD
U01682Medicare UPIN
KS0000005091OtherBLUE CROSS/BLUE SHIELD
0313780001Medicare NSC