BEACON MEDICAL GROUP INC. NPI 1114363835

NPI Information

BEACON MEDICAL GROUP, INC. is a family medicine in Middlebury, IN. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. BEACON MEDICAL GROUP, INC. NPI is 1114363835. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Beacon Medical Group Middlebury.

The provider's business location address is:

206 W WARREN ST
MIDDLEBURY, IN
ZIP 46540-410
Phone: (574) 825-2146
Fax: (574) 524-7435

The provider's authorized official is Jeffrey P. Costello .
The authorized official title is Cfo and has the following contact phone number (574) 647-3549.

The CLIA number assigned to this NPI record is 15D0356768 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/21/2013 and was last updated on 3/4/2024.

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:

Other Identifiers

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