1881602217 NPI number — MR. JOHN P BEILMAN NP

Table of content: MR. JOHN P BEILMAN NP (NPI 1881602217)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881602217 NPI number — MR. JOHN P BEILMAN NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BEILMAN
Provider First Name:
JOHN
Provider Middle Name:
P
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881602217
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/29/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 E. HOSPITAL ROAD
Provider Second Line Business Mailing Address:
DEPT OF MED. CARDIOLOGY
Provider Business Mailing Address City Name:
FORT GORDON
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30905
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
706-787-0684
Provider Business Mailing Address Fax Number:
706-787-9237

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 E. HOSPITAL ROAD
Provider Second Line Business Practice Location Address:
DEPARTMENT OF MEDICINE; CARDIOLOGY
Provider Business Practice Location Address City Name:
FORT GORDON
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30905-5650
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-787-0684
Provider Business Practice Location Address Fax Number:
706-787-9237
Provider Enumeration Date:
08/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2100X , with the licence number:  2918 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 202G700025 , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".




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