Healthcare Provider Details
I. General information
NPI: 1558382184
Provider Name (Legal Business Name): BEACON FAMILY MEDICINE, LLP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
130 COUNTY RD
IPSWICH MA
01938-2585
US
IV. Provider business mailing address
130 COUNTY RD
IPSWICH MA
01938-2585
US
V. Phone/Fax
- Phone: 978-356-1192
- Fax: 978-356-9943
- Phone: 978-356-1192
- Fax: 978-356-9943
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 173000000X |
| Taxonomy | Legal Medicine |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CURTIS
P
ERSING
Title or Position: PARTNER
Credential:
Phone: 978-356-1192