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General NPI Number Information
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NPI Number | 1386670065
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Entity Type | Organization
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Legal Business Name | BEACON ORTHOPAEDICS & SPORTS MEDICINE, LTD
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Dates
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Enumeration Date | 06/24/2006
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 500 E BUSINESS WAY
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City | CINCINNATI
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State | OH
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Zip | 45241-2374
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Country | US
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Telephone | 513-354-3700
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Fax | 513-354-3705
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Provider Business Mailing Address
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Address Line | 6480 HARRISON AVE STE 201
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City | CINCINNATI
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State | OH
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Zip | 45247-7961
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Country | US
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Telephone | 513-354-3700
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Fax | 513-354-7651
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Authorized Official
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Title or Position | CEO
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Name | MR. TIMOTHY YUCKMAN
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Credential |
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Telephone | 513-354-7785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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