Provider Demographics
NPI:1407906134
Name:BEACHUM, STEVEN RAY (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:RAY
Last Name:BEACHUM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 STAD AVE
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:TN
Mailing Address - Zip Code:38261-5541
Mailing Address - Country:US
Mailing Address - Phone:731-885-2555
Mailing Address - Fax:731-885-6093
Practice Address - Street 1:1312 STAD AVE
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-5541
Practice Address - Country:US
Practice Address - Phone:731-885-2555
Practice Address - Fax:731-885-6093
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000000628111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3674955Medicare PIN
TNT81702Medicare UPIN