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Contact Information

THEO J BEACH JR, PA-C
131 E MARKET ST
SMITHFIELD, NC27577-3915
 Phone: 919-934-5441
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Vascular & Interventional Radiology

2085R0204X 94 Physician/Interventional Radiology
Indicates primary specialty

NPI Profile & details for THEO J BEACH JR · (Male)

NPI Number 1710533286
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 08/12/2019
Last updated 08/01/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • NC License # 0010-09318
Hospital affiliation(s)
  • CAPE FEAR VALLEY MEDICAL CENTER - (Acute Care)
    1638 OWEN DRIVE P O BOX 2000
    FAYETTEVILLE, NC 28302
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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