MEDICARE: MR. ERIC WILLIAM BEACH PA-C

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	363A00000X	Physician Assistant	6203	TN
2	363A00000X	Physician Assistant	PA9108387	FL
3	363AS0400X	Surgical Physician Assistant	PA9108387	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316343593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ERIC WILLIAM BEACH PA-C

Provider Business Mailing Address
First Line	:	144 JACK FARRAR LN
Second Line	:
City	:	TULLAHOMA
State	:	TN
Zip	:	37388-2398
Country	:	US
Telephone Number	:	931-962-2272
Fax Number	:

Provider Business Practice Location Address
First Line	:	144 JACK FARRAR LN
Second Line	:
City	:	TULLAHOMA
State	:	TN
Zip	:	37388-2398
Country	:	US
Telephone Number	:	931-962-2272
Fax Number	:

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

Provider Enumeration Date	:	11/14/2014
Last Update Date	:	04/10/2026

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