Provider Demographics
NPI:1598872632
Name:BEAHM, THOMAS MARION (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:MARION
Last Name:BEAHM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 28415
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37424-8415
Mailing Address - Country:US
Mailing Address - Phone:423-485-9200
Mailing Address - Fax:423-485-9204
Practice Address - Street 1:1949 GUNBARREL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3186
Practice Address - Country:US
Practice Address - Phone:423-485-9200
Practice Address - Fax:423-485-9204
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN147042086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00801611XMedicaid
TN0101OtherJOHN DEERE
0044234OtherBCBS
240004779OtherRAILROAD MEDICARE
5226416OtherAETNA
621656859OtherAETNA, UNITED, CIGNA
TN3001086Medicaid
5867028OtherAETNA
3001086Medicare ID - Type Unspecified
0044234OtherBCBS