| Organization Name: | BEACON MEDICAL GROUP, INC. |
| NPI Number: | 1447203674 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEFFREY COSTELLO (VP-CFO) |
| Mailing Address: | 100 Navarre Pl Suite 4440 South Bend |
| State: | IN US |
| Postal Code: | 466011156 |
| Phone Number: | 5746474540 |
| Fax Number: | 5746474542 |
| NPI Enumeration Date: | 05/18/2006 |
| NPI Last Update Date: | 03/09/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208000000X |
| License Number: | 01046281A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Pediatrics |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |