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NPI Code Detail

MEDICARE: REBECCA ELIZABETH BEAUDOIN DO

MEDICARE: REBECCA ELIZABETH BEAUDOIN DO
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
1390200000XStudent in an Organized Health Care Education/Training Program
2208000000XPediatrics PhysicianW5265TX

General Provider Information

NPI Number : 1295430791
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA ELIZABETH BEAUDOIN DO
Provider Business Mailing Address
First Line : 4502 E 41ST ST
Second Line :
City : TULSA
State : OK
Zip : 74135-2536
Country : US
Telephone Number : 918-619-4400
Fax Number : 918-619-4334
Provider Business Practice Location Address
First Line : 4502 E 41ST ST
Second Line :
City : TULSA
State : OK
Zip : 74135-2536
Country : US
Telephone Number : 918-619-4400
Fax Number : 918-619-4334
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2023
Last Update Date : 05/07/2026

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Directions to “ REBECCA ELIZABETH BEAUDOIN DO” Practice Location

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