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Individual

DR. GARY HAMPTON BEACHUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
101 E STATE ST, MAIL BOX 192, ITHACA, NY 14850-5543
(919) 450-7666
Mailing address
101 E STATE ST, MAIL BOX 192, ITHACA, NY 14850-5543
(919) 450-7666

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
192184-1
NY

Other

Enumeration date
06/03/2007
Last updated
07/08/2007
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