Individual
DR. THOMAS BASS BEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5480 GOODMAN RD STE 3, OLIVE BRANCH, MS 38654-7902
(662) 893-9815
(662) 893-9888
Mailing address
1211 UNION AVE STE 330, MEMPHIS, TN 38104-6655
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
23320
MS
208600000X
Surgery Physician
52023
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00276815
—
MS
01
—
6020201
BCBS
TN
01
—
P01440718
RAILROAD MEDICARE
MS
05
—
Q008144
—
TN
Enumeration date
05/13/2009
Last updated
04/24/2025
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