Beaty, Samantha T.
Beaty, Samantha T. is an sole proprietor health care provider with primary practice located at 1310 East Walker Street , Fulton MS 38843. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Beaty, Samantha T. can be contacted via phone (662) 862-6727.Contact Information
Primary practice address
1310 East Walker Street
Fulton MS 38843
Phone: (662) 862-6727
Fax: (662) 862-7969
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 668 | Mississippi |
Profile Details
| NPI number | 1952485112 |
|---|---|
| LBN Legal business name | Beaty, Samantha T. |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 24th, 2006 |
| Last updated | Jul 11th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952485112 | NPPES |
| Mississippi | MEDICAID | 00880181 |
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