Organization
MICHAEL E BEATTY, M.D., P.C.
Active
Other names
SOUTHWESTERN ILLINOIS PLASTIC & HAND SURGERY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS HAROLD YATES (PRACTICE ADMINISTRATOR)
(618) 656-9355
Entity
Organization
Contact information
Practice address
2 SUNSET HILLS PROFESSIONAL CTR, EDWARDSVILLE, IL 62025-3760
(618) 656-9355
(618) 692-9880
Mailing address
2 SUNSET HILLS PROFESSIONAL CTR, EDWARDSVILLE, IL 62025-3760
(618) 656-9355
(618) 692-9880
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
962560
OLD MEDICARE PTAN #
IL
Enumeration date
12/27/2006
Last updated
03/18/2009
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