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Individual

BRENT W BEASLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
16659 E 23RD ST S, INDEPENDENCE, MO 64055-1922
(816) 688-6000
(816) 631-1885
Mailing address
PO BOX 740019, ATLANTA, GA 30374-0019
(312) 733-9730

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
18452
OK
207R00000X
Internal Medicine Physician
Primary
2023008158
MO
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
0426982
KS
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
2000163858
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0401810
UNITED HEALTHCARE
MO
01
186249
COVENTRY
MO
01
200189777
HUMANA
MO
01
27634041
BLUE CROSS BLUE SHIELD
MO
01
5612302005
CIGNA
MO
01
5682498
AETNA
MO
Enumeration date
05/03/2006
Last updated
03/08/2023
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