Provider Demographics
NPI:1609820349
Name:BEECH, JAMES WILSON (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WILSON
Last Name:BEECH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 HATCHER LANE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-3536
Mailing Address - Country:US
Mailing Address - Phone:931-388-0965
Mailing Address - Fax:931-388-0966
Practice Address - Street 1:1404 HATCHER LANE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-3536
Practice Address - Country:US
Practice Address - Phone:931-388-0965
Practice Address - Fax:931-388-0966
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC260111N00000X
CO4022111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3672204Medicare ID - Type Unspecified
T74497Medicare UPIN