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Individual

DR. JOHN P BEAVERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
1401 JEFFERSON HWY, NEW ORLEANS, LA 70121-2426
(504) 842-4747
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2483
(504) 842-3000

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4704234332
MI
363L00000X
Nurse Practitioner
Primary
4704234332
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1003066143
MI
01
500C961050
BCBSM
MI
Enumeration date
09/25/2008
Last updated
07/24/2025
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