Provider Demographics
NPI:1972049716
Name:BELDEN OPTOMETRY LLC
Entity type:Organization
Organization Name:BELDEN OPTOMETRY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESBYOPIA
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:HULTS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:330-697-4748
Mailing Address - Street 1:4157 BELDEN VILLAGE MALL
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2501
Mailing Address - Country:US
Mailing Address - Phone:330-494-4140
Mailing Address - Fax:866-425-2239
Practice Address - Street 1:4157 BELDEN VILLAGE MALL
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2501
Practice Address - Country:US
Practice Address - Phone:330-494-4140
Practice Address - Fax:866-425-2239
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR. RICHARD E. HULTS & ASSOC, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3420/T494152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty