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Individual

CARL JONATHAN BEECROFT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
15810 S 45TH ST, PHOENIX, AZ 85048-7697
(480) 893-1090
(480) 598-1458
Mailing address
15810 S 45TH ST, PHOENIX, AZ 85048-7697
(480) 893-1090
(480) 598-1458

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
626
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0653000001
DMERC
AZ
01
P00423174
RAILROAD MC
AZ
Enumeration date
08/02/2005
Last updated
07/14/2011
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