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General NPI Number Information
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NPI Number | 1801891742
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Entity Type | Individual
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Provider Name | WILLIAM E. BEATY PH.D.
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Gender | Male
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 10/13/2015
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Provider Practice Location Address
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Address Line | 5214 SW 91ST WAY #120
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City | GAINESVILLE
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State | FL
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Zip | 32608-4172
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Country | US
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Telephone | 352-331-5520
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Fax | 352-331-6323
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Provider Business Mailing Address
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Address Line | PO BOX 357703
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City | GAINESVILLE
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State | FL
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Zip | 32635-7703
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Country | US
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Telephone | 352-331-5520
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Fax | 352-331-6323
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY0003468
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License Number State | FL
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