Individual
DR. GARTH MERVID BEACHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
530 S JACKSON ST, SUITE C07, LOUISVILLE, KY 40202-1675
(502) 852-5875
(502) 852-1754
Mailing address
PO BOX 21249, LOUISVILLE, KY 40221-0249
(502) 581-1500
(502) 540-4959
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
40968
KY
2085R0202X
Diagnostic Radiology Physician
D0051294
MD
2085R0204X
Vascular & Interventional Radiology Physician
40968
KY
2085R0204X
Vascular & Interventional Radiology Physician
D0051294
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000522619
ANTHEM
KY
05
—
200897990
—
IN
01
—
40968
LICENSE
KY
01
—
D0051294
LICENSE
MD
01
—
P00413991
RAILROAD MCR
KY
Enumeration date
10/13/2006
Last updated
02/09/2009
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