| Doctor Name: | MR. MAXIE E BEATY |
| NPI Number: | 1801002571 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 3041 S Ford Rd Byrdstown, TN - 385494347 |
| Business Phone Number: | 9318646797 |
| Business Fax Number: | 9318646797 |
| Mailing Address: | 3041 S Ford Rd, BYRDSTOWN |
| State: | TN |
| Postal Code: | 385494347 |
| Phone Number: | 9318646797 |
| Fax Number: | 9318646797 |
| NPI Enumeration Date: | 05/16/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 347C00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Private Vehicle |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual paid to provide non-emergency transportation using their privately owned/leased vehicle. |