Healthcare Provider Details

I. General information

NPI: 1710942388
Provider Name (Legal Business Name): WILLIAM T BEECROFT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 S PENNSYLVANIA AVE
LANSING MI
48910-3488
US

IV. Provider business mailing address

PO BOX 977
OKEMOS MI
48805-0977
US

V. Phone/Fax

Practice location:
  • Phone: 517-377-8510
  • Fax: 517-377-8803
Mailing address:
  • Phone: 517-336-6997
  • Fax: 517-336-6989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number4301043531
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: