Beaty, Kenneth Dale
Beaty, Kenneth Dale is an sole proprietor health care provider with primary practice located at 100 Old Jefferson , Celina TN 38551-0217. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Beaty, Kenneth Dale can be contacted via phone (931) 243-6725.Contact Information
Primary practice address
100 Old Jefferson
Celina TN 38551-0217
Phone: (931) 243-6725
Fax: (931) 243-6727
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 34968 | Tennessee |
Profile Details
| NPI number | 1255364782 |
|---|---|
| LBN Legal business name | Beaty, Kenneth Dale |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 8th, 2006 |
| Last updated | Jul 9th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255364782 | NPPES |
| Tennessee | MEDICAID | 3861533 |
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