Individual
JERRY STEPHEN BEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1119 E COLLEGE ST, STE 3, PULASKI, TN 38478
(931) 424-8881
(931) 424-5385
Mailing address
1119 E COLLEGE ST, STE 3, PULASKI, TN 38478
(931) 424-8881
(931) 424-5385
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26439
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3088920
—
TN
Enumeration date
09/29/2006
Last updated
06/23/2010
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