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NPI Code Detail

MEDICARE: LAWRENCE T BEATTY MD

MEDICARE: LAWRENCE T BEATTY 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
1207Q00000XFamily Medicine PhysicianMD019252EPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417906413
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAWRENCE T BEATTY MD
Provider Business Mailing Address
First Line : 201 COLLEGE PARK PLAZA
Second Line : SUITE 2
City : JOHNSTOWN
State : PA
Zip : 15904-2833
Country : US
Telephone Number : 814-266-8800
Fax Number : 814-266-8175
Provider Business Practice Location Address
First Line : 201 COLLEGE PARK PLAZA
Second Line : SUITE 2
City : JOHNSTOWN
State : PA
Zip : 15904-2833
Country : US
Telephone Number : 814-266-8800
Fax Number : 814-266-8175
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2006
Last Update Date : 07/08/2007

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