Individual
GARY D BEAUCHAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1530 N CHURCH RD, LIBERTY, MO 64068-7129
(816) 781-1696
(816) 781-5438
Mailing address
5501 NW 62ND TER, SUITE 201, KANSAS CITY, MO 64151-2411
(816) 584-8884
(913) 588-9220
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
04-14844
KS
207RC0000X
Cardiovascular Disease Physician
Primary
R5969
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04472015
BCBS KC
—
01
—
051563
BCBS KS OUTREACH CLINICS
KS
01
—
10001216901
COMMUNITY HLTH PLAN OF MO
—
05
—
100202570A
—
KS
05
—
100202570B
—
KS
01
—
151824XX
PREFERRED CARE NY
—
05
—
200019503
—
MO
01
—
225043
HEALTHLINK-NCPPO
—
01
—
4001285
MO & KS / AETNA PPO & HMO
—
01
—
504290
FIRST GUARD HLTH PLAN
—
01
—
557640
FAMILY HEALTH PARTNERS
—
Enumeration date
07/24/2006
Last updated
12/18/2013
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