Provider Demographics
NPI:1912051996
Name:HUGH BEATTY, M.D., INC.
Entity Type:Organization
Organization Name:HUGH BEATTY, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:
Authorized Official - Last Name:BEATTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-395-0315
Mailing Address - Street 1:PO BOX 22315
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93390-2315
Mailing Address - Country:US
Mailing Address - Phone:661-395-0315
Mailing Address - Fax:661-335-7766
Practice Address - Street 1:6001 TRUXTUN AVE STE 240
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0675
Practice Address - Country:US
Practice Address - Phone:661-395-0315
Practice Address - Fax:661-335-7766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG59385207L00000X, 207LP2900X
CAG593850208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E02880Medicare UPIN