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
Phone: (574) 948-5100
Fax: (574) 348-0745
Website:
Health care specialties
| Specialty | Code | License # | 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 8 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 | 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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