Individual provider · NPI-1

David Jarrod Beachum, PA-C

Physician Assistant · Jackson, TN

NPI number1881244259
StatusActive
Last updated in NPPESSep 17, 2019

Details

NPI
1881244259
Entity type
Individual (NPI-1)
Name
David Jarrod Beachum
Credential
PA-C
Sex
Male
Sole proprietor
No
Enumeration date
Sep 17, 2019
Last updated
Sep 17, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant3932TNYes

Practice location

149 N Star Dr
Jackson, TN 38305-5634

Phone 731-664-6998

Mailing address

149 N Star Dr
Jackson, TN 38305-5634

Phone 731-664-6998

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