Provider Demographics
NPI:1710155106
Name:STEVEN R BEACHUM
Entity Type:Organization
Organization Name:STEVEN R BEACHUM
Other - Org Name:FAMILY CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:BEACHUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-885-2555
Mailing Address - Street 1:1312 STAD AVE
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:TN
Mailing Address - Zip Code:38261-5541
Mailing Address - Country:US
Mailing Address - Phone:731-885-2555
Mailing Address - Fax:731-885-6093
Practice Address - Street 1:1312 STAD AVE
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-5541
Practice Address - Country:US
Practice Address - Phone:731-885-2555
Practice Address - Fax:731-885-6093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000000628111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3675504Medicare PIN