Organization
BEACON PRIMARY CARE LLC
Active
Organization
BEACON PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER DONALD FARR (OWNER)
(317) 559-7970
Entity
Organization
Contact information
Practice address
10967 ALLISONVILLE RD STE 110, FISHERS, IN 46038-2634
(317) 599-5970
Mailing address
10967 ALLISONVILLE RD STE 110, FISHERS, IN 46038-2634
(317) 559-5970
(317) 559-7971
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IN3378
MEDICARE PTAN
IN
Enumeration date
10/19/2016
Last updated
01/07/2020
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