Basic Information
| Provider Information | |||||||||
| NPI: | 1407859275 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BEYER | ||||||||
| FirstName: | TODD | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 518 WEST AVE | ||||||||
| Address2: | |||||||||
| City: | TALLMADGE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 442782117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3306309699 | ||||||||
| FaxNumber: | 3306302173 | ||||||||
| Practice Location | |||||||||
| Address1: | 518 WEST AVE | ||||||||
| Address2: | |||||||||
| City: | TALLMADGE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 442782117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3306309699 | ||||||||
| FaxNumber: | 3306302173 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2005 | ||||||||
| LastUpdateDate: | 03/19/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207WX0200X | 4290 | OH | N | 207W00000X | 4290 | OH | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | 40625101 | 01 | UNITED HEALTHCARE | OTHER | 0657105 | 05 | OH | MEDICAID | 000000134337 | 01 | ANTHEM | OTHER | 180017837 | 01 | OH | RAILROAD MEDICARE | OTHER | 4044067 | 01 | AETNA | OTHER |