Healthcare Provider Details

I. General information

NPI: 1528025335
Provider Name (Legal Business Name): JEAN M BEISCHEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 05/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 ROAD 46 WEST
BATESVILLE IN
47006
US

IV. Provider business mailing address

124 ROAD 46 WEST
BATESVILLE IN
47006
US

V. Phone/Fax

Practice location:
  • Phone: 812-933-6000
  • Fax: 812-933-0921
Mailing address:
  • Phone: 812-933-6000
  • Fax: 812-933-0921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number35-05-7714
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01040135A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: