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General NPI Number Information
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NPI Number | 1083060321
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Entity Type | Individual
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Provider Name | ANDREW BEYKE MA ATC
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Gender | Male
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Dates
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Enumeration Date | 05/05/2016
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Last Update Date | 05/05/2016
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Provider Practice Location Address
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Address Line | 1810 MANNING WAY
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City | UNIVERISTY
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State | MS
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Zip | 38677
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Country | US
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Telephone | 662-915-1375
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Fax | 662-915-7617
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Provider Business Mailing Address
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Address Line | 101 MICHAEL DR
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City | OXFORD
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State | MS
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Zip | 38655-4218
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Country | US
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Telephone | 662-816-0167
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Fax | 662-915-7617
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT0769
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License Number State | MS
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