Provider Demographics
NPI:1225008188
Name:BEALS, NORMAN K III (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:K
Last Name:BEALS
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 802
Mailing Address - Street 2:ONE PARK WAY
Mailing Address - City:SENECA
Mailing Address - State:PA
Mailing Address - Zip Code:16346-0802
Mailing Address - Country:US
Mailing Address - Phone:814-676-5444
Mailing Address - Fax:814-676-0342
Practice Address - Street 1:ONE PARK WAY
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:PA
Practice Address - Zip Code:16346-0802
Practice Address - Country:US
Practice Address - Phone:814-676-5444
Practice Address - Fax:814-676-0342
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2014-09-18
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Provider Licenses
StateLicense IDTaxonomies
PAMD040161L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010877870003Medicaid
PA020615430OtherTAX ID NUMBER
PA46-4444529OtherTAX ID NUMBER
PA46-4444529OtherTAX ID NUMBER