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NPI Code Detail

MEDICARE: DR. SHAWN BEASLEY D.C.

MEDICARE:  DR. SHAWN  BEASLEY  D.C.
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
1111N00000XChiropractor1607AR

General Provider Information

NPI Number : 1700821055
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHAWN BEASLEY D.C.
Provider Business Mailing Address
First Line : 4102 JEFFERSON AVE
Second Line :
City : TEXARKANA
State : AR
Zip : 71854-1512
Country : US
Telephone Number : 870-779-9924
Fax Number : 870-779-9329
Provider Business Practice Location Address
First Line : 4102 JEFFERSON AVE
Second Line :
City : TEXARKANA
State : AR
Zip : 71854-1512
Country : US
Telephone Number : 870-779-9924
Fax Number : 870-779-9329
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2006
Last Update Date : 07/08/2007

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Directions to “ DR. SHAWN BEASLEY D.C.” Practice Location

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