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Individual

ROY D BEEBE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2 SIMSBURY RD, AVON, CT 06001
(860) 679-6600
(860) 679-6604
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
18635
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001186352
CT
01
010018635CT03
BCBS
CT
01
1588621221
MEDICAID - UCONN
CT
01
602316
CONNECTICARE
CT
01
D400063551
MEDICARE - UCONN
CT
Enumeration date
04/27/2006
Last updated
08/03/2012
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