Provider Demographics
NPI:1306899240
Name:EUGENE, BEATRIXE CLAUDE (DO)
Entity type:Individual
Prefix:DR
First Name:BEATRIXE
Middle Name:CLAUDE
Last Name:EUGENE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 TREEMONT WAY
Mailing Address - Street 2:
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-2881
Mailing Address - Country:US
Mailing Address - Phone:305-491-4135
Mailing Address - Fax:
Practice Address - Street 1:248 E CROGAN ST STE 2
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-5069
Practice Address - Country:US
Practice Address - Phone:305-491-4135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8049207R00000X
GA58174207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL51597RMedicare PIN
FL279961800Medicaid