Individual
JAMES BEITZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1270 E STATE ROAD 205, SUITE 210, COLUMBIA CITY, IN 46725-9499
(260) 248-9230
(260) 248-9249
Mailing address
11109 PARKVIEW PLAZA DR STE 3, FORT WAYNE, IN 46845-1701
(260) 266-6013
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01061931A
IN
207R00000X
Internal Medicine Physician
MD034166E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000513051
ANTHEM
IN
01
—
000000570559
ANTHEM
IN
05
—
001083302
—
PA
01
—
1194655
CIGNA
IN
05
—
200855470
—
IN
01
—
21412
PHP
IN
01
—
351972384027
TRICARE
IN
01
—
3937240002
MEDICARE DMEPOS
IN
01
—
4239333
AETNA
IN
01
—
P00465455
RAILROAD MEDICARE
IN
Enumeration date
06/09/2005
Last updated
10/17/2022
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