Individual provider · Type 1 NPI

Jordan Alexander Beacham, MD

Student in an Organized Health Care Education/Training Program · Philadelphia, PA

NPI number 1629915640 Active

Practice location

833 Chestnut St
Philadelphia, PA 19107-4414

Call (215) 955-1085 Map

Fax (215) 955-5041

Mailing address

833 Chestnut St Fl 1
Philadelphia, PA 19107-4404

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1629915640

Jordan Alexander Beacham, MD's National Provider Identifier is 1629915640, issued on Apr 29, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Philadelphia, PA. The record was last updated on Apr 29, 2026.