Individual
DR. JACOB LYNDON BELTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-6220
(706) 721-8623
Mailing address
1120 15TH ST # OR6000, AUGUSTA, GA 30912-0004
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101284920
VA
2085R0204X
Vascular & Interventional Radiology Physician
0101284920
VA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
90876
GA
208D00000X
General Practice Physician
90876
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
90876
GEORGIA MEDICAL COMPOSITE BOARD
GA
Enumeration date
08/27/2013
Last updated
02/19/2026
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