Provider Demographics
NPI:1144474362
Name:BEACHAM, ARTHUR DOUGLAS III (DO)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:DOUGLAS
Last Name:BEACHAM
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9800 BROADWAY EXT STE 203
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-6304
Mailing Address - Country:US
Mailing Address - Phone:405-424-5415
Mailing Address - Fax:405-424-5416
Practice Address - Street 1:9800 BROADWAY EXT STE 203
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-6304
Practice Address - Country:US
Practice Address - Phone:405-424-5415
Practice Address - Fax:405-424-5416
Is Sole Proprietor?:No
Enumeration Date:2008-11-14
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5351208VP0014X, 208VP0014X
KY03466207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKFB3143992OtherDEA
KY7100229560Medicaid