Provider Demographics
NPI:1013200963
Name:BEARD, JEFF HIXON (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFF
Middle Name:HIXON
Last Name:BEARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 CAPTAIN ONEAL DR
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-4023
Mailing Address - Country:US
Mailing Address - Phone:251-621-1011
Mailing Address - Fax:
Practice Address - Street 1:1011 CAPTAIN ONEAL DR
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-4023
Practice Address - Country:US
Practice Address - Phone:251-621-1011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2819208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology