Provider Demographics
NPI:1396535779
Name:BEAM, GEORGIA EILEEN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:GEORGIA
Middle Name:EILEEN
Last Name:BEAM
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7128 MCNARNEY AVE UNIT D
Mailing Address - Street 2:
Mailing Address - City:TINKER AFB
Mailing Address - State:OK
Mailing Address - Zip Code:73145-4708
Mailing Address - Country:US
Mailing Address - Phone:405-474-5995
Mailing Address - Fax:
Practice Address - Street 1:6101 W RENO AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127-6542
Practice Address - Country:US
Practice Address - Phone:405-495-3085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6651225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist