Provider Demographics
NPI:1891969846
Name:TRUXTON, BEVERLY HAINES (MD)
Entity Type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:HAINES
Last Name:TRUXTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ECWA/SIM
Mailing Address - Street 2:PMB 2009
Mailing Address - City:JOS
Mailing Address - State:PLS
Mailing Address - Zip Code:234
Mailing Address - Country:NG
Mailing Address - Phone:07-345-4098
Mailing Address - Fax:
Practice Address - Street 1:200 SAWMILL RD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2707
Practice Address - Country:US
Practice Address - Phone:856-857-0468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-21
Last Update Date:2008-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02607200208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice