Provider Demographics
NPI:1013150580
Name:BEATTY, JASON L (DO)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:L
Last Name:BEATTY
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1185 US HIGHWAY 23 N
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-8004
Mailing Address - Country:US
Mailing Address - Phone:989-736-8157
Mailing Address - Fax:989-358-3763
Practice Address - Street 1:165 N STATE AVE
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-2835
Practice Address - Country:US
Practice Address - Phone:517-881-6199
Practice Address - Fax:989-340-1512
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2025-01-06
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Provider Licenses
StateLicense IDTaxonomies
MI5101018107207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine