Individual
JACK GRAY BEAIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
407 W 66TH ST, RICHFIELD, MN 55423-2374
(612) 798-8800
(612) 798-8816
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
21323
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194380400
—
MN
Enumeration date
04/17/2006
Last updated
11/06/2020
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