Beazlie-Walker, Sally

Beazlie-Walker, Sally is an sole proprietor health care provider with primary practice located at 209 E Jefferson St , Plymouth IN 46563-1861. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Beazlie-Walker, Sally can be contacted via phone (574) 948-5100.

Contact Information

Primary practice address
209 E Jefferson St Plymouth IN 46563-1861
Fax: (574) 348-0745
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 02005023A Indiana

Profile Details

NPI number 1437312980
LBN Legal business name Beazlie-Walker, Sally
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 4th, 2008
Last updated Jun 16th, 2018 - about 7 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 1437312980 NPPES
Indiana Other 187720067 MEDICARE PTAN
Indiana Other P01887772 MEDICARE PTAN
Indiana Other 000001109741 MEDICARE PTAN
Indiana MEDICAID 300004357 MEDICARE PTAN

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