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Organization
BLAKE R. BEAZER, M.D., INC
Active
Organization
BLAKE R. BEAZER, M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BLAKE RICHARD BEAZER M.D. (MEDICAL DOCTOR)
(435) 882-2358
Entity
Organization
Contact information
Practice address
2356 N 400 E, STE. 201, TOOELE, UT 84074-3409
(435) 882-2350
(435) 882-2039
Mailing address
2356 N 400 E, STE. 201, TOOELE, UT 84074-3409
(435) 882-2350
(435) 882-2039
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
52480801205
UT
Other
Enumeration date
12/14/2007
Last updated
01/10/2014
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