Individual
BEAU PHILIP GEDRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4490 WASHINGTON RD STE 2, EVANS, GA 30809-5899
(762) 930-3539
(706) 391-4250
Mailing address
4490 WASHINGTON RD STE 2, EVANS, GA 30809-5899
(762) 930-3539
(706) 391-4250
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
075463
GA
207PS0010X
Sports Medicine (Emergency Medicine) Physician
Primary
075463
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003173115B
—
GA
Enumeration date
04/07/2010
Last updated
12/06/2023
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