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General NPI Number Information
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NPI Number | 1073533063
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Entity Type | Individual
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Provider Name | REBECCA BEACH MD
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Gender | Female
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 01/03/2020
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Provider Practice Location Address
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Address Line | 504 N FAIR OAKS AVE
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City | MADISON
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State | WI
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Zip | 53714-1556
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Country | US
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Telephone | 608-577-3109
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Fax | 608-835-2648
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Provider Business Mailing Address
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Address Line | 301 E 2ND ST
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City | RICHLAND CENTER
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State | WI
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Zip | 53581-1900
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Country | US
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Telephone | 608-647-6161
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 33607
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License Number State | WI
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