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NPI Code Detail

MEDICARE: DR. RICHARD LEE BEASLEY MD

MEDICARE: DR. RICHARD LEE BEASLEY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician3782SD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24995691OTHERSDWELLMARK BCBS

General Provider Information

NPI Number : 1093785735
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD LEE BEASLEY MD
Provider Business Mailing Address
First Line : 5410 SHERIDAN LAKE RD
Second Line :
City : RAPID CITY
State : SD
Zip : 57702-9208
Country : US
Telephone Number : 605-348-4141
Fax Number : 605-342-7880
Provider Business Practice Location Address
First Line : 5410 SHERIDAN LAKE RD
Second Line :
City : RAPID CITY
State : SD
Zip : 57702-9208
Country : US
Telephone Number : 605-348-4141
Fax Number : 605-342-7880
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2006
Last Update Date : 12/04/2009

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