Provider Demographics
NPI:1497804058
Name:MARK E BEAUGARD MD FACS
Entity Type:Organization
Organization Name:MARK E BEAUGARD MD FACS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:COFFEY
Authorized Official - Last Name:BEAUGARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-692-0800
Mailing Address - Street 1:520 MAPLE AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4434
Mailing Address - Country:US
Mailing Address - Phone:610-692-0800
Mailing Address - Fax:610-692-8299
Practice Address - Street 1:520 MAPLE AVE STE 1
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4434
Practice Address - Country:US
Practice Address - Phone:610-692-0800
Practice Address - Fax:610-692-8299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
050939Medicare UPIN