Provider Demographics
NPI:1528210911
Name:SANDRA R. BEICHLER, D.O., INC.
Entity Type:Organization
Organization Name:SANDRA R. BEICHLER, D.O., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:BEICHLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:330-493-8580
Mailing Address - Street 1:6310 MIDDLEBRANCH AVE NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44721-3555
Mailing Address - Country:US
Mailing Address - Phone:330-493-8580
Mailing Address - Fax:330-493-8540
Practice Address - Street 1:6310 MIDDLEBRANCH AVE NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44721-3555
Practice Address - Country:US
Practice Address - Phone:330-493-8580
Practice Address - Fax:330-493-8540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34003309208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0487101Medicaid
OH0487101Medicaid