Provider Demographics
NPI:1447402268
Name:BEACON PROFESSIONAL SERVICES, PLC
Entity Type:Organization
Organization Name:BEACON PROFESSIONAL SERVICES, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:AMEEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-685-4265
Mailing Address - Street 1:1240 OLD WEISGARBER RD STE B
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2683
Mailing Address - Country:US
Mailing Address - Phone:865-685-4265
Mailing Address - Fax:865-862-8983
Practice Address - Street 1:1240 OLD WEISGARBER RD STE B
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2683
Practice Address - Country:US
Practice Address - Phone:865-685-4265
Practice Address - Fax:865-862-8983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-13
Last Update Date:2008-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN406042084A0401X, 2084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty