Healthcare Provider Details

I. General information

NPI: 1871563015
Provider Name (Legal Business Name): JAMES R. BEYMER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 11/04/2021
Certification Date: 11/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 WEST BYPASS
DRUMRIGHT OK
74030-5954
US

IV. Provider business mailing address

612 W BYPASS
DRUMRIGHT OK
74030-5957
US

V. Phone/Fax

Practice location:
  • Phone: 918-352-2555
  • Fax: 918-352-4709
Mailing address:
  • Phone: 918-382-5955
  • Fax: 918-382-5970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number3441
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: