Basic Information
| Provider Information | |||||||||
| NPI: | 1457363053 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MACBEATH | ||||||||
| FirstName: | BLAIR | ||||||||
| MiddleName: | REID | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2701 US HIGHWAY 271 N | ||||||||
| Address2: | |||||||||
| City: | PITTSBURG | ||||||||
| State: | TX | ||||||||
| PostalCode: | 756864289 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9039465442 | ||||||||
| FaxNumber: | 9039465258 | ||||||||
| Practice Location | |||||||||
| Address1: | 2701 US HIGHWAY 271 N | ||||||||
| Address2: | |||||||||
| City: | PITTSBURG | ||||||||
| State: | TX | ||||||||
| PostalCode: | 756864289 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9039465442 | ||||||||
| FaxNumber: | 9039465258 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2006 | ||||||||
| LastUpdateDate: | 04/15/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | F8936 | TX | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.