Provider Demographics
NPI:1043252042
Name:BEIGHT, JOHN LAWTON (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:LAWTON
Last Name:BEIGHT
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 1:7500 CENTRAL AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-2430
Mailing Address - Country:US
Mailing Address - Phone:215-745-4050
Mailing Address - Fax:215-745-9333
Practice Address - Street 1:7500 CENTRAL AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-2430
Practice Address - Country:US
Practice Address - Phone:215-745-4050
Practice Address - Fax:215-745-9333
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039910E207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
F31843Medicare UPIN
PA728929Medicare PIN