Provider Demographics
NPI:1851540223
Name:BEARD, JEFFREY H (PA-C)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:H
Last Name:BEARD
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 WHIPPOORWILL LN
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37022-8358
Mailing Address - Country:US
Mailing Address - Phone:615-888-1011
Mailing Address - Fax:
Practice Address - Street 1:100 B MALLARD SUNRISE DRIVE
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:WESTMORELAND
Practice Address - State:TN
Practice Address - Zip Code:37186
Practice Address - Country:US
Practice Address - Phone:615-644-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1616363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant