Individual
DR. JUSTIN F BEATTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2616 MESILLA ST NE STE 3, ALBUQUERQUE, NM 87110-3659
(505) 503-6300
Mailing address
2616 MESILLA ST NE STE 3, ALBUQUERQUE, NM 87110-3659
(505) 503-6300
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD2018-1001
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD2018-1001
NEW MEXICO MEDICAL LICENSE
NM
01
—
RS2015-0384
NEW MEXICO STATE TRAINING LICENSE
NM
Enumeration date
04/08/2015
Last updated
06/27/2024
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