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General NPI Number Information
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NPI Number | 1598767774
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Entity Type | Individual
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Provider Name | HARLEY S BEASLEY MD
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Gender | Male
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 09/27/2024
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Provider Practice Location Address
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Address Line | 2101 W ARLINGTON BLVD STE 210
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City | GREENVILLE
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State | NC
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Zip | 27834-5758
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Country | US
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Telephone | 252-931-7638
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Fax | 252-931-7694
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Provider Business Mailing Address
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Address Line | PO BOX 30750
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City | GREENVILLE
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State | NC
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Zip | 27833-0750
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Country | US
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Telephone | 252-931-7638
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Fax | 252-931-7694
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 2024-01476
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD065242L
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License Number State | PA
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