MEDICARE: ARTHUR DOUGLAS BEACHAM III D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0014X	Interventional Pain Medicine Physician	5351	OK

General Provider Information

NPI Number	:	1144474362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARTHUR DOUGLAS BEACHAM III D.O.

Provider Business Mailing Address
First Line	:	9800 BROADWAY EXT STE 203
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73114-6304
Country	:	US
Telephone Number	:	405-424-5415
Fax Number	:	405-424-5416

Provider Business Practice Location Address
First Line	:	9800 BROADWAY EXT STE 203
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73114-6304
Country	:	US
Telephone Number	:	405-424-5415
Fax Number	:	405-424-5416

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2008
Last Update Date	:	01/07/2019

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