Individual
ERIC BEATTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
775 WAUKEGAN RD, SUITE 200, DEERFIELD, IL 60015-4342
(800) 317-0711
(800) 434-7113
Mailing address
756 S FRED SHUTTLESWORTH CIR, CINCINNATI, OH 45229-2113
(513) 579-0022
(800) 434-7113
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36003367B
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000380377
ANTHEM BCBS
OH
01
—
000000518078
ANTHEM BCBS
IN
05
—
200827490
—
IN
05
—
2451912
—
OH
Enumeration date
06/28/2006
Last updated
05/09/2008
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