Provider Demographics
NPI:1699722249
Name:BEYER, DIRK MICHAEL (OD)
Entity type:Individual
Prefix:DR
First Name:DIRK
Middle Name:MICHAEL
Last Name:BEYER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2068
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-4068
Mailing Address - Country:US
Mailing Address - Phone:406-363-2020
Mailing Address - Fax:406-363-0646
Practice Address - Street 1:820 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-2330
Practice Address - Country:US
Practice Address - Phone:406-363-2020
Practice Address - Fax:406-363-0646
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT634152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0481321Medicaid
MT4452900001OtherNORIDIAN MEDICARE
MT000027171OtherBLUE CROSS BLUE SHIELD
MT000027171OtherBLUE CROSS BLUE SHIELD
MT000025038Medicare PIN