Individual
DR. DONALD J BEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8854 W EMERALD ST STE 150, BOISE, ID 83704-4844
(208) 229-2368
(888) 815-1621
Mailing address
8854 W EMERALD ST STE 150, BOISE, ID 83704-4844
(208) 229-2368
(888) 815-1651
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
M-7576
ID
207Y00000X
Otolaryngology Physician
M7576
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010004823
BLUE SHIELD
ID
01
—
000010004824
BLUE SHIELD
ID
01
—
040013862
RAILROAD MEDICARE
ID
01
—
38117
BLUE CROSS
ID
05
—
805241200
—
ID
01
—
DM735
BLUE CROSS
ID
Enumeration date
10/21/2005
Last updated
05/25/2021
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