Healthcare Provider Details

I. General information

NPI: 1457585341
Provider Name (Legal Business Name): KARL J. BEER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2009
Last Update Date: 10/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2865 N REYNOLDS RD SUITE 160
TOLEDO OH
43615-2068
US

IV. Provider business mailing address

2865 N REYNOLDS RD SUITE 160
TOLEDO OH
43615-2068
US

V. Phone/Fax

Practice location:
  • Phone: 419-578-4260
  • Fax: 419-537-5630
Mailing address:
  • Phone: 419-578-4260
  • Fax: 419-537-5630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateOH

VIII. Authorized Official

Name: AMY L BAHNSEN
Title or Position: SENIOR CREDENTIALING COORDINATOR
Credential:
Phone: 419-824-7334