MEDICARE: DR. ROBERT H BEASLEY M.D.

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
1	2084P0800X	Psychiatry Physician	9931	OK

General Provider Information

NPI Number	:	1235138314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT H BEASLEY M.D.

Provider Business Mailing Address
First Line	:	701 MARKET DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73114-8132
Country	:	US
Telephone Number	:	405-951-3732
Fax Number	:	405-951-3916

Provider Business Practice Location Address
First Line	:	701 MARKET DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73114-8132
Country	:	US
Telephone Number	:	405-951-3732
Fax Number	:	405-951-3916

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	10/27/2011

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