Provider Demographics
NPI:1396747523
Name:BEZIER, JEFFREY L (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:L
Last Name:BEZIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 WATERFORD PIKE
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15825-2518
Mailing Address - Country:US
Mailing Address - Phone:814-849-8344
Mailing Address - Fax:814-849-7130
Practice Address - Street 1:50 WATERFORD PIKE
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:PA
Practice Address - Zip Code:15825-2518
Practice Address - Country:US
Practice Address - Phone:814-849-8344
Practice Address - Fax:814-849-7130
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029181E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1210272Medicaid
CF3515OtherRAILROAD MEDICARE GROUP #
PA614146OtherMEDICARE GROUP PTAN
P00355451OtherRR MEDICARE INDIVIDUAL
CF3515OtherRAILROAD MEDICARE GROUP #