Provider Demographics
NPI:1093731341
Name:BEYER, HALLIE JEANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:HALLIE
Middle Name:JEANNE
Last Name:BEYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:H. JEANNE
Other - Middle Name:
Other - Last Name:BEYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:16666-0068
Mailing Address - Country:US
Mailing Address - Phone:814-339-7101
Mailing Address - Fax:814-339-6165
Practice Address - Street 1:330 ENTERPRISE DR STE B
Practice Address - Street 2:
Practice Address - City:PHILIPSBURG
Practice Address - State:PA
Practice Address - Zip Code:16866-3174
Practice Address - Country:US
Practice Address - Phone:814-342-6636
Practice Address - Fax:814-342-5230
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD018469E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006830240001Medicaid
PA0006830240001Medicaid