Provider Demographics
NPI:1922037704
Name:BEATTIE, JAMES R III (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:BEATTIE
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 BUNN DR.
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-1968
Mailing Address - Country:US
Mailing Address - Phone:609-921-2800
Mailing Address - Fax:609-921-3499
Practice Address - Street 1:800 BUNN DR.
Practice Address - Street 2:SUITE 101
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-1968
Practice Address - Country:US
Practice Address - Phone:609-921-2800
Practice Address - Fax:609-921-3499
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06411500207RC0000X, 207UN0901X
PAMD058669L207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
060044849OtherMEDICARE FED RAILROAD
PA0994292000OtherKEYSTONE HEALTHPLAN
994292000OtherAMERIHEALTH HMO
223258770OtherBEECHSTREET
NJ7634200Medicaid
694828OtherAETNA US HEALTHCARE
881472OtherAMERIHEALTH ADMINISTRATOR
994292000OtherINDEPENDENCE PERSONAL CHO
223258770OtherAARP HEALTH INSURANCE
223258770OtherCHN
223258770OtherHORIZON BLUE CROSS BLUE S
223258770OtherGREATWEST
881472OtherBLUE SHIELD PENNSYLVANIA
223258770OtherCIGNA
223258770OtherDEVON
223258770OtherGHI
5636285OtherAETNA US HEALTHCARE
F05564OtherHEALTNET
223258770OtherCHN
881472OtherAMERIHEALTH ADMINISTRATOR