Healthcare Provider Details

I. General information

NPI: 1437723038
Provider Name (Legal Business Name): ERIC CHRISTOPHER BEAUJON DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2021
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 E WATERLOO RD
AKRON OH
44319-1218
US

IV. Provider business mailing address

335 E WATERLOO RD
AKRON OH
44319-1218
US

V. Phone/Fax

Practice location:
  • Phone: 330-724-8689
  • Fax:
Mailing address:
  • Phone: 330-724-8689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36.004161
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: