Individual
MRS. DIANE K BEEBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2500 NORTH STATE STREET, DEPT OF FAMILY MEDICINE, JACKSON, MS 39216
(601) 984-6800
(601) 984-6812
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-4778
(601) 984-5420
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10757
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0112681
—
MS
01
—
080105952
RAILROAD
MS
01
—
P00620205
RAILROAD MEDICARE PTAN
MS
Enumeration date
09/26/2006
Last updated
02/13/2014
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