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NPI Code Detail

MEDICARE: DR. BRIGITTE BEAUDRY M.D.

MEDICARE: DR. BRIGITTE BEAUDRY M.D.
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
1174400000XSpecialistL5244TX
2207L00000XAnesthesiology Physician34768CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518960897
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIGITTE BEAUDRY M.D.
Provider Business Mailing Address
First Line : PO BOX 150
Second Line :
City : HOLLY
State : CO
Zip : 81047-0150
Country : US
Telephone Number : 719-537-0712
Fax Number : 719-537-6284
Provider Business Practice Location Address
First Line : 11600 W 2ND PL
Second Line :
City : LAKEWOOD
State : CO
Zip : 80228-1527
Country : US
Telephone Number : 720-321-1048
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2005
Last Update Date : 08/01/2012

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