Individual
DR. FRED EUGENE BEALL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
902 E LAMAR ST, AMERICUS, GA 31709-3741
(122) 992-8996
(122) 992-8995
Mailing address
PO BOX 1431, AMERICUS, GA 31709-1431
(122) 992-8996
(122) 992-8995
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
011073
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00507284A
—
GA
Enumeration date
09/27/2006
Last updated
07/09/2007
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