Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 2819 | AL |
NPI | 1013200963 |
---|---|
Provider Name | Dr. Jeff Hixon Beard |
First Address | Daphne, AL 36526-4023 |
Second Address | Daphne, AL 36526-4023 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2011 |
Last Update Date | 25/05/2011 |