MEDICARE: DR. CHARLES ALLEN BEARD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	N7014	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	080008207	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033102637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES ALLEN BEARD MD

Provider Business Mailing Address
First Line	:	605 EUREKA AVE STE C
Second Line	:
City	:	BERRYVILLE
State	:	AR
Zip	:	72616-3035
Country	:	US
Telephone Number	:	479-253-6007
Fax Number	:	479-253-9877

Provider Business Practice Location Address
First Line	:	25 NORRIS ST
Second Line	:
City	:	EUREKA SPRINGS
State	:	AR
Zip	:	72632-3508
Country	:	US
Telephone Number	:	479-253-6007
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	12/17/2020

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