MEDICARE: WILLIAM J BEATON JR. DPM

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	213E00000X	Podiatrist	PO-0000312	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1972507382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM J BEATON JR. DPM

Provider Business Mailing Address
First Line	:	6707 38TH AVE N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33710-1536
Country	:	US
Telephone Number	:	727-896-4615
Fax Number	:	727-256-3855

Provider Business Practice Location Address
First Line	:	6707 38TH AVE N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33710-1536
Country	:	US
Telephone Number	:	727-896-4615
Fax Number	:	727-256-3855

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

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	08/26/2020

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Directions to “ WILLIAM J BEATON JR. DPM” Practice Location

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