Provider Demographics
NPI:1386750651
Name:BEAUCHAMP, JOSEPH O (MD)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:O
Last Name:BEAUCHAMP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 7TH AVE S
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-6715
Mailing Address - Country:US
Mailing Address - Phone:239-263-7425
Mailing Address - Fax:239-263-3430
Practice Address - Street 1:811 7TH AVE S
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6715
Practice Address - Country:US
Practice Address - Phone:239-263-7425
Practice Address - Fax:239-263-3430
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLLL484207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD52083Medicare UPIN