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General NPI Number Information
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NPI Number | 1639178064
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Entity Type | Individual
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Provider Name | TIMOTHY B BEATTY D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 05/01/2009
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Provider Practice Location Address
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Address Line | 501 ROBERTSON BLVD
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City | WALTERBORO
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State | SC
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Zip | 29488-2787
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Country | US
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Telephone | 843-497-5929
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Fax | 843-497-9940
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Provider Business Mailing Address
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Address Line | 4615 OLEANDER DR
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City | MYRTLE BEACH
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State | SC
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Zip | 29577-5741
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Country | US
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Telephone | 843-497-5929
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Fax | 843-497-9940
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 911
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License Number State | SC
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