Healthcare Provider Details

I. General information

NPI: 1760445852
Provider Name (Legal Business Name): RONALD G BEEBE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 11/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 S ENOTA DR NE
GAINESVILLE GA
30501
US

IV. Provider business mailing address

950 S ENOTA DR NE
GAINESVILLE GA
30501-2413
US

V. Phone/Fax

Practice location:
  • Phone: 770-536-0470
  • Fax: 770-536-3031
Mailing address:
  • Phone: 770-536-0470
  • Fax: 770-536-3031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number030006
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: