Provider Demographics
NPI:1790045680
Name:BEARD, CARRIE (DO)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:
Last Name:BEARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 590
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:WV
Mailing Address - Zip Code:24983-0590
Mailing Address - Country:US
Mailing Address - Phone:304-772-3064
Mailing Address - Fax:304-772-3296
Practice Address - Street 1:200 HEALTH CENTER DR
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:WV
Practice Address - Zip Code:24983-8442
Practice Address - Country:US
Practice Address - Phone:304-772-3064
Practice Address - Fax:304-772-3296
Is Sole Proprietor?:No
Enumeration Date:2012-05-24
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSLP-1380235Z00000X
WV3862207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist