| Beau Pittman | |
|
8001 Centerview Pkwy Ste 218 Cordova TN 38018-4228 | |
| (901) 756-1216 | |
| (901) 756-1412 |
| Full Name | Beau Pittman |
|---|---|
| Speciality | Internal Medicine |
| Location | 8001 Centerview Pkwy Ste 218, Cordova, Tennessee |
| Authorized Official Name and Position | Beau B. Pittman (OWNER) |
| Authorized Official Contact | 9017561216 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beau Pittman 8001 Centerview Pkwy Ste 218 Cordova TN 38018-4228 Ph: (901) 756-1216 | Beau Pittman 8001 Centerview Pkwy Ste 218 Cordova TN 38018-4228 Ph: (901) 756-1216 |
| NPI Number | 1417123084 |
|---|---|
| Provider Enumeration Date | 05/05/2008 |
| Last Update Date | 04/04/2022 |
| Medicare PECOS PAC ID | 1951470426 |
|---|---|
| Medicare Enrollment ID | O20080523000276 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417123084 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Tennessee) | Primary |
| Provider Name | Beau Pittman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780684696 PECOS PAC ID: 5597834069 Enrollment ID: I20080523000272 |
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