Organization
BEACON PEDIATRICS
Active
Other names
DAVID H. CHEATHAM, M.D.,P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KITTY CHEATHAM LPN, RMM (OFFICE MANAGER)
(912) 285-2440
Entity
Organization
Contact information
Practice address
801 BEACON ST, WAYCROSS, GA 31501-7109
(912) 285-2440
(912) 287-0197
Mailing address
801 BEACON ST, WAYCROSS, GA 31501-7109
(912) 285-2440
(912) 287-0197
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
045745
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000797024D
—
GA
Enumeration date
01/09/2008
Last updated
07/31/2013
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