Individual
DR. JOHN JOHNSON BEASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
132 ARBOR CREST DR, MAYFIELD, KY 42066-1233
(270) 247-8710
(270) 247-9564
Mailing address
132 ARBOR CREST DR, MAYFIELD, KY 42066-1233
(270) 247-8710
(270) 247-9564
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25079
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000059857
ANTHEM BCBS
KY
01
—
300011148
RAILROAD MEDICARE
KY
05
—
64250798
—
KY
Enumeration date
12/08/2005
Last updated
10/26/2011
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