Provider Demographics
NPI:1366449498
Name:BEATTY, JAMES F (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:F
Last Name:BEATTY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 551420
Mailing Address - Street 2:B336
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33355-1420
Mailing Address - Country:US
Mailing Address - Phone:800-243-3839
Mailing Address - Fax:954-839-2569
Practice Address - Street 1:1968 PEACHTREE ROAD NW
Practice Address - Street 2:B336
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1281
Practice Address - Country:US
Practice Address - Phone:404-351-1745
Practice Address - Fax:404-351-7121
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2011-07-21
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Provider Licenses
StateLicense IDTaxonomies
NH11983174400000X
GA035813207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000659865AMedicaid
NH30203994Medicaid
GA05BDDSBMedicare ID - Type Unspecified
GA000659865AMedicaid