Beacon Medical Group, Inc.

NPI #1053361543 in Granger, Indiana

Provider Information

NPI Number: 1053361543
Entity Type: Organization
Organization Name: Beacon Medical Group, Inc.
Primary Specialty: Family Medicine
Enumeration Date: May 12, 2006
Last Updated: Aug 26, 2024

Practice Location

Address: 6913 N MAIN ST STE 300
City: Granger
State: Indiana
ZIP Code: 46530-8039
Phone: (574) 647-1500

Authorized Official

Name: JEFFREY COSTELLO
Title: VP-CFO
Phone: (574) 647-3549

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X
Nurse Practitioner - Family — Family	363LF0000X
Internal Medicine	207R00000X
Internal Medicine - Rheumatology — Rheumatology	207RR0500X
Family Medicine	207Q00000X	Primary

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