Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
BEAU PHILIP GEDRICK, D.O.
Active Sole ProprietorBEAU PHILIP GEDRICK, D.O. is a Sports Medicine (EM) healthcare provider located in EVANS, Georgia. NPI 1679899215 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine (EM) · EVANS, GA
Registration Details
- NPI Number
- 1679899215
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 7, 2010 (16.166918451238 yrs)
- Last Updated
- Dec 6, 2023
- Licenses
-
075463 (GA)075463 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4490 WASHINGTON RD STE 2EVANS, GA, 308095899Browse GA providers · Browse ZIP 30809
- Phone
- 7629303539
- Fax
- 7063914250
- Primary Specialty
-
Sports Medicine (EM)
207PS0010X
- Additional Specialty
- Sports Medicine (EM)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.