MR. JACOB LYNDON BELTZ MD NPI 1609200633

NPI Information

NPI: 1609200633
Provider Name: MR. JACOB LYNDON BELTZ, MD
Classification: Radiology - 2085R0204X
Entity Type: Individual

Specialization: Vascular & Interventional Radiology

PECOS Registration: Yes

Address:
1120 15TH ST
AUGUSTA, GA
ZIP 30912
Phone: (706) 721-8623
Get Directions

MR. Jacob Lyndon Beltz, MD is a vascular and interventional radiology radiology in Augusta, GA with 7 years of experience. The provider is a radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. MR. Jacob Lyndon Beltz, MD NPI is 1609200633. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MERCER UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2017

The provider's business location address is:

1120 15TH ST
AUGUSTA, GA
ZIP 30912-220
Phone: (706) 721-8623

The NPI 1609200633 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/27/2013 and was last updated on 3/1/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice		90876	GEORGIA	No
2	390200000X	Student in an Organized Health Care Education/Training Program				No
3	2085R0204X	Radiology	Vascular & Interventional Radiology	90876	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	90876	OTHER	GEORGIA	GEORGIA MEDICAL COMPOSITE BOARD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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