Individual
DEAN A. BEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
100 NORTHCREST DR, SPRINGFIELD, TN 37172-3927
(615) 384-2411
Mailing address
PO BOX 634706, CINCINNATI, OH 45263-0001
(865) 292-3000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA103
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3668614
—
TN
01
—
4083270
BLUECROSS
TN
01
—
P00285985
RAILROAD MEDICARE
TN
Enumeration date
06/20/2006
Last updated
11/12/2007
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