Healthcare Provider Details

I. General information

NPI: 1154753739
Provider Name (Legal Business Name): BEAU RYAN BEARD D.C., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2013
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 NARROWS PKWY STE A
BIRMINGHAM AL
35242-8649
US

IV. Provider business mailing address

203 NARROWS PKWY STE A
BIRMINGHAM AL
35242-8649
US

V. Phone/Fax

Practice location:
  • Phone: 205-419-1595
  • Fax: 205-724-9130
Mailing address:
  • Phone: 205-419-1595
  • Fax: 205-724-9130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number2415
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: