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BEAU TAYLOR VANDIVER MD NPI 1861981102


NPI Information

NPI: 1861981102
Provider Name: BEAU TAYLOR VANDIVER, MD
Classification: Plastic Surgery - 2082S0099X
Entity Type: Individual

Specialization: Plastic Surgery Within the Head and Neck

PECOS Registration: Yes

Address:
2700 HIGHWAY 280 S STE 300
MOUNTAIN BRK, AL
ZIP 35223
Phone: (205) 930-9595
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Beau Taylor Vandiver, MD is a plastic surgery within the head and neck plastic surgery in Mountain Brk, AL with 6 years of experience. The provider is a plastic surgeon with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgery is practiced, there are many additional procedures which interface with them. Beau Taylor Vandiver, MD NPI is 1861981102. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2700 HIGHWAY 280 S STE 300
MOUNTAIN BRK, AL
ZIP 35223-445
Phone: (205) 930-9595
Fax: (205) 802-7719

The NPI 1861981102 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 5/2/2018 and was last updated on 6/13/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1390200000XStudent in an Organized Health Care Education/Training ProgramNo
22082S0099XPlastic SurgeryPlastic Surgery Within the Head and Neck39047ALABAMAYes

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.