Provider Demographics
NPI:1467625244
Name:LIGHTHOUSE RADIOLOGY, PLLC
Entity Type:Organization
Organization Name:LIGHTHOUSE RADIOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEODIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-252-7447
Mailing Address - Street 1:1 HARDY HILL RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03766-2012
Mailing Address - Country:US
Mailing Address - Phone:603-252-7447
Mailing Address - Fax:603-658-0484
Practice Address - Street 1:600 SAINT JOHNSBURY RD
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561-3442
Practice Address - Country:US
Practice Address - Phone:603-444-9577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty