Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 017773 | GA |
NPI | 1326020231 |
---|---|
Provider Name | Philip H Beegle JR. |
First Address | Atlanta, GA 30342-1619 |
Second Address | Atlanta, GA 30342-1619 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2005 |
Last Update Date | 08/07/2007 |