Healthcare Provider Details

I. General information

NPI: 1366627341
Provider Name (Legal Business Name): THOMAS F BEESON MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 01/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 WILSON ST
MILES CITY MT
59301-5094
US

IV. Provider business mailing address

PO BOX 220
MILES CITY MT
59301-0220
US

V. Phone/Fax

Practice location:
  • Phone: 406-233-2543
  • Fax: 406-233-2567
Mailing address:
  • Phone: 406-233-2543
  • Fax: 406-233-2567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number6915
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number6915
License Number StateMT

VIII. Authorized Official

Name: THOMAS F BEESON
Title or Position: OWNER
Credential: MD
Phone: 406-233-2543