Joseph Louis Beaudrot, MD
Individual provider Active NPI Obstetrics & Gynecology Physician · Greenwood, SC
NPI 1144286089 · NPPES record last updated Aug 18, 2011
Key facts
- NPI
- 1144286089
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 12789 (SC)
- Practice address
- 106 Liner Drive
Greenwood, SC 29646 - Phone
- (864) 227-6371
- Fax
- (864) 227-6345
- NPI assigned
- Apr 20, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 12789 | SC | Yes |
Addresses
Primary practice location
106 Liner Drive
Greenwood, SC 29646
Mailing address
106 Liner Drive
Greenwood, SC 29646
Phone (864) 227-6371
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 127892 | Medicaid | SC |
Other providers in Greenwood, SC
- Ashley S Batson
- Amylynn Battles
- Gustavo Z Bazan
- Beam & Flynn Inc
- John B Beasley
- Makeia Brenee Beck
- Angelia Graham Bell
- Ashley Rebekah Bell
- Charles Bell
- Christina Bell
All providers in Greenwood, SC · Obstetrics & Gynecology Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.