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Individual

ALLEN RANDLE BEECHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2000 VILLAGE PROFESSIONAL DR, SUITE 200, CANTON, GA 30114-8498
(678) 661-4545
Mailing address
2000 VILLAGE PROFESSIONAL DR, SUITE 200, CANTON, GA 30114-8498
(678) 661-4545

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
025102
GA
207Q00000X
Family Medicine Physician
025102
GA
208VP0000X
Pain Medicine Physician
Primary
025102
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000318447G
GA
Enumeration date
07/05/2006
Last updated
03/29/2023
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