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General NPI Number Information
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NPI Number | 1033776588
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Entity Type | Individual
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Provider Name | JOHN B BEASLEY MD
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Gender | Male
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Dates
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Enumeration Date | 05/21/2019
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 355 CAMBRIDGE AVE W
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City | GREENWOOD
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State | SC
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Zip | 29646-2191
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Country | US
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Telephone | 864-396-5268
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Fax | 864-396-5269
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Provider Business Mailing Address
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Address Line | 313 MAIN ST STE B
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City | GREENWOOD
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State | SC
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Zip | 29646-2757
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Country | US
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Telephone | 864-388-0301
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Fax | 864-943-1120
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 82314
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License Number State | SC
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