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Individual

LAEL J. BEACHLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
777 AVENUE H, POWELL, WY 82435-2260
(307) 754-9191
(307) 754-1291
Mailing address
777 AVENUE H, POWELL, WY 82435-2260
(307) 754-9191
(307) 754-1291

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
139
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12407172
CAQH
WY
01
1245365154
MEDICARE GROUP
WY
05
133719000
WY
01
5804674
CIGNA
WY
01
P01142512
RAILROAD MEDICARE EMPLOYEE PTAN
WY
Enumeration date
04/16/2009
Last updated
02/12/2015
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