Beacon Medical Group, Inc.

NPI #1184641706 in Wakarusa, Indiana

Provider Information

NPI Number: 1184641706
Entity Type: Organization
Organization Name: Beacon Medical Group, Inc.
Primary Specialty: Family Medicine
Enumeration Date: Jul 17, 2006
Last Updated: Mar 4, 2024

Practice Location

Address: 207 N ELKHART ST
City: Wakarusa
State: Indiana
ZIP Code: 46573-9729
Phone: (574) 862-2165

Authorized Official

Name: MR. JEFFREY P COSTELLO
Title: CFO
Phone: (574) 647-3549

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse Practitioner - Family — Family	363LF0000X
Family Medicine	207Q00000X	Primary

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