Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 11098 | TN |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 11098 | TN |
NPI | 1457347171 |
---|---|
Provider Name | Dr. James H Beaty |
First Address | Germantown, TN 38138-2205 |
Second Address | Germantown, TN 38138-2205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2005 |
Last Update Date | 01/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00011188 | (05) | MS |
107276001 | (05) | AR |
B04494 | (02) | TN |
Q016954 | (05) | TN |