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NPI Code Detail

MEDICARE: JOHN P BEAUVAIS M.D.

MEDICARE: JOHN P BEAUVAIS M.D.
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
12085R0202XDiagnostic Radiology Physician18068NE

General Provider Information

NPI Number : 1548229743
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN P BEAUVAIS M.D.
Provider Business Mailing Address
First Line : PO BOX 103
Second Line :
City : YUTAN
State : NE
Zip : 68073-0103
Country : US
Telephone Number : 308-647-6444
Fax Number : 308-647-6433
Provider Business Practice Location Address
First Line : 4600 38TH ST
Second Line :
City : COLUMBUS
State : NE
Zip : 68601-1664
Country : US
Telephone Number : 308-647-6444
Fax Number : 308-647-6433
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 11/15/2010

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