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General NPI Number Information
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NPI Number | 1770573750
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Entity Type | Individual
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Provider Name | DONALD J BEASLEY MD
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Gender | Male
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Dates
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Enumeration Date | 10/21/2005
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Last Update Date | 05/25/2021
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Provider Practice Location Address
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Address Line | 8854 W EMERALD ST STE 150
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City | BOISE
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State | ID
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Zip | 83704-4844
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Country | US
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Telephone | 208-229-2368
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Fax | 888-815-1621
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Provider Business Mailing Address
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Address Line | 8854 W EMERALD ST STE 150
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City | BOISE
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State | ID
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Zip | 83704-4844
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Country | US
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Telephone | 208-229-2368
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Fax | 888-815-1651
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | M-7576
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | M7576
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License Number State | ID
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