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General NPI Number Information
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NPI Number | 1659541373
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Entity Type | Organization
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Legal Business Name | R W. BEATTY, M.D., INC.
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Dates
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Enumeration Date | 03/10/2008
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 517 BROADWAY ST 500
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City | EAST LIVERPOOL
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State | OH
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Zip | 43920-3167
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Country | US
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Telephone | 330-385-9494
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Fax | 330-385-1735
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Provider Business Mailing Address
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Address Line | 517 BROADWAY ST 500
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City | EAST LIVERPOOL
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State | OH
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Zip | 43920-3167
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Country | US
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Telephone | 330-385-9494
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Fax | 330-385-1735
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT WALKER BEATTY
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Credential | M.D.
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Telephone | 330-385-9494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35030071
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License Number State | OH
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