Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 35058194 | OH |
NPI | 1649263971 |
---|---|
Provider Name | Allan C Beebe |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43215-5577 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2005 |
Last Update Date | 30/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0747713 | (05) | OH |
64055346 | KY MEDICAID (01) | KY |
9801467000 | (05) | WV |
E54289 | (02) | OH |