Basic Information
Provider Information
NPI: 1487623484
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BEUERLEIN
FirstName: FRANK
MiddleName: JOSEPH
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 30309
Address2:  
City: CHARLESTON
State: SC
PostalCode: 294170309
CountryCode: US
TelephoneNumber: 8435549300
FaxNumber: 8435668780
Practice Location
Address1: 501 19TH ST
Address2: SUITE 301
City: KNOXVILLE
State: TN
PostalCode: 379161854
CountryCode: US
TelephoneNumber: 8655227591
FaxNumber: 8655259662
Other Information
ProviderEnumerationDate: 03/14/2006
LastUpdateDate: 02/29/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZC0500XMD18330TNN Allopathic & Osteopathic PhysiciansPathologyCytopathology
207ZP0102XMD18330TNY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

ID Information
IDTypeStateIssuerDescription
303001505TN MEDICAID
404872201TNBCBSOTHER


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