Individual
JILL BEAVINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
806 JACKSON ST, COLUMBUS, IN 47201
(812) 748-3412
(812) 748-3412
Mailing address
806 JACKSON ST, COLUMBUS, IN 47201-6264
(812) 748-3412
(812) 748-3412
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01054606
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200285110
—
IN
Enumeration date
11/01/2006
Last updated
07/24/2018
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