Individual
ROBERT BEALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
619 OLD SYMSONIA ROAD, SUITE A, BENTON, KY 42025-5042
(270) 527-7400
(270) 527-2211
Mailing address
619 OLD SYMSONIA ROAD, SUITE A, BENTON, KY 42025-5042
(270) 527-7400
(270) 527-2211
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
KY32012
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000056871
BLUE CROSS & BLUE SHIELD
KY
01
—
000000386630
BLUE CROSS AND BLUE SHIEL
KY
01
—
020030282
RR MEDICARE
KY
05
—
64320120
—
KY
01
—
P00386601
RR MEDICARE
KY
Enumeration date
07/19/2006
Last updated
09/30/2009
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