Individual
DR. NOLAN JACKSON BEAVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D,
Contact information
Practice address
2337 G ST, BELLEVILLE, KS 66935-2463
(785) 527-2217
(785) 527-5929
Mailing address
2337 G ST, BELLEVILLE, KS 66935-2463
(785) 527-2217
(785) 527-5929
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-30225
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100642760C
—
KS
Enumeration date
09/14/2006
Last updated
01/23/2009
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