Provider Demographics
NPI:1871685842
Name:BEATTY, DAVID AYERS (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:AYERS
Last Name:BEATTY
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 1:2738 CLAIRMONT RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-2713
Mailing Address - Country:US
Mailing Address - Phone:404-636-6500
Mailing Address - Fax:404-363-6072
Practice Address - Street 1:2738 CLAIRMONT RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-2713
Practice Address - Country:US
Practice Address - Phone:404-636-6500
Practice Address - Fax:404-363-6072
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR001561111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU41783Medicare UPIN
GAGRP2388Medicare ID - Type Unspecified