Healthcare Provider Details

I. General information

NPI: 1447206784
Provider Name (Legal Business Name): PETER A BEATTY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 05/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 JOHN Q HAMMONS DR DEAN HEMATOLOGY & ONCOLOGY CENTER
MADISON WI
53717-1959
US

IV. Provider business mailing address

1200 JOHN Q HAMMONS DR DEAN HEMATOLOGY & ONCOLOGY CENTER
MADISON WI
53717-1959
US

V. Phone/Fax

Practice location:
  • Phone: 608-410-2700
  • Fax: 608-410-2901
Mailing address:
  • Phone: 608-410-2700
  • Fax: 608-410-2901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number26243-020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: