Healthcare Provider Details

I. General information

NPI: 1659959286
Provider Name (Legal Business Name): ADAM HENRY BEIGHLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2021
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 E 2ND ST
CASPER WY
82609-4293
US

IV. Provider business mailing address

6501 E 2ND ST
CASPER WY
82609-4293
US

V. Phone/Fax

Practice location:
  • Phone: 307-235-5433
  • Fax:
Mailing address:
  • Phone: 307-235-5433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberTL9171
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: