Individual
DR. PAUL KEVIN BEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 STARLING STREET, SUITE 201, BRUNSWICK, GA 31520-4267
(912) 265-5125
(912) 261-0907
Mailing address
2500 STARLING STREET, SUITE 201, BRUNSWICK, GA 31520-4267
(912) 265-5125
(912) 261-0907
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
63629
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0489056
AETNA
SC
05
—
707667089A
—
GA
01
—
P00067751
RR MEDICARE
SC
Enumeration date
10/12/2006
Last updated
09/18/2023
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