Beacon Medical Group, Inc.

NPI #1639129117 in La Porte, Indiana

Provider Information

NPI Number: 1639129117
Entity Type: Organization
Organization Name: Beacon Medical Group, Inc.
Primary Specialty: Family Medicine
Enumeration Date: May 12, 2006
Last Updated: Mar 4, 2024

Practice Location

Address: 900 I ST
City: La Porte
State: Indiana
ZIP Code: 46350-5533
Phone: (219) 324-1700

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Obstetrics & Gynecology	207V00000X
Nurse Practitioner	363L00000X
Family Medicine	207Q00000X	Primary

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