Beacon Medical Group, Inc.
NPI #1114363835 in Middlebury, Indiana
Provider Information
- NPI Number
- 1114363835
- Entity Type
- Organization
- Organization Name
- Beacon Medical Group, Inc.
- Primary Specialty
- Family Medicine
- Enumeration Date
- May 21, 2013
- Last Updated
- Mar 4, 2024
Practice Location
- Address
- 206 W WARREN ST
- City
- Middlebury
- State
- Indiana
- ZIP Code
- 46540-9410
- Phone
- (574) 825-2146
Authorized Official
- Name
- MR. JEFFREY P. COSTELLO
- Title
- CFO
- Phone
- (574) 647-3549
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Family — Family |
| Family Medicine |
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