Basic Information
| Provider Information | |||||||||
| NPI: | 1376528067 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BEECH | ||||||||
| FirstName: | JOYCE | ||||||||
| MiddleName: | WAGNER | ||||||||
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| Credential: | PAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4515 PREMIER DR | ||||||||
| Address2: | SUITE 204 | ||||||||
| City: | HIGH POINT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272658357 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368022075 | ||||||||
| FaxNumber: | 3368022076 | ||||||||
| Practice Location | |||||||||
| Address1: | 4515 PREMIER DR | ||||||||
| Address2: | SUITE 204 | ||||||||
| City: | HIGH POINT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272658357 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368022075 | ||||||||
| FaxNumber: | 3368022076 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2005 | ||||||||
| LastUpdateDate: | 03/26/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 000100618 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.