MEDICARE: JOHN K BEIGHLE DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	113	MT
2	213ES0131X	Foot Surgery Podiatrist	113	MT
3	363LF0000X	Family Nurse Practitioner	219938	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000007931	OTHER	MT	BCBS

General Provider Information

NPI Number	:	1386642577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN K BEIGHLE DPM

Provider Business Mailing Address
First Line	:	1801 SELWAY DR
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59808-9314
Country	:	US
Telephone Number	:	406-240-4593
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 SELWAY DR
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59808-9314
Country	:	US
Telephone Number	:	406-240-4593
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	12/20/2024

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Directions to “ JOHN K BEIGHLE DPM” Practice Location

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