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General NPI Number Information
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NPI Number | 1528278074
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Entity Type | Individual
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Provider Name | ELEANE MARIE BEADLE MD
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Gender | Female
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 05/28/2020
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Provider Practice Location Address
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Address Line | 1 JARRETT WHITE RD TRIPLER ARMY MEDICAL CENTER
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City | HONOLULU
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State | HI
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Zip | 96859-5001
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Country | US
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Telephone | 808-433-6661
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Fax | 253-968-5926
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Provider Business Mailing Address
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Address Line | 1 JARRETT WHITE RD TRIPLER ARMY MEDICAL CENTER
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City | HONOLULU
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State | HI
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Zip | 96859-5001
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Country | US
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Telephone | 808-433-6661
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Fax | 253-968-5926
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 24031
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 24031
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License Number State | NE
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