Beaver, Walter R

Beaver, Walter R is an individual health care provider with primary practice located at 3 Professional Park Dr Suite 21, Johnson City TN 37604-6529. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Beaver, Walter R can be contacted via phone (423) 434-6300.

Contact Information

Primary practice address
3 Professional Park Dr Suite 21 Johnson City TN 37604-6529
Phone: (423) 434-6300
Fax: (423) 434-6312
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 9453 Tennessee

Profile Details

NPI number 1417927211
LBN Legal business name Beaver, Walter R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2006
Last updated May 5th, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417927211 NPPES
Tennessee MEDICAID 3172495
Tennessee MEDICAID 5903974

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