Organization
PLATINUM ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY BEACHAM MD (OWNER)
(601) 918-5567
Entity
Organization
Contact information
Practice address
4205 SPRINGHURST BLVD STE 101, LOUISVILLE, KY 40241-6159
(502) 352-2530
Mailing address
7145 E VIRGINIA ST STE 2000, EVANSVILLE, IN 47715-9147
(812) 962-7894
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
—
—
207LH0002X
Hospice and Palliative Medicine (Anesthesiology) Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100756810
—
KY
Enumeration date
04/26/2021
Last updated
06/01/2022
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