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DR. TIMOTHY L BEECHNAU D.O.

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1083619936

Individual Registrant:
DR. TIMOTHY L BEECHNAU D.O.
Gender: M
Sole Proprietor

Location and contact information for practice:
12520 CROCKERY CREEK DR.  RAVENNA, MI 49451 US
Tel: 231-853-6725  Fax: 231-853-6089

Contact information for business:
PO BOX 179  RAVENNA, MI 49451-0179 US
Tel: 231-853-6725  Fax: 231-853-6089

Registration Information:
NPI: 1083619936
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
MI008430

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
PRIORITY HEALTH383249263MI01
AETNA4098417MI01
BCBS5610010MI01
TAX ID383249263MA01
4480790MI05
BCN5610010MI01




HEALTH CARE JOBS MI - Page 1



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