MEDICARE: DR. JEFFREY PAUL BEACH DO

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	207L00000X	Anesthesiology Physician	DR.77618	CO
2	207L00000X	Anesthesiology Physician	94-11008	KS
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1710628086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY PAUL BEACH DO

Provider Business Mailing Address
First Line	:	KUMC 3901 RAINBOW BLVD MS 1034
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-0001
Country	:	US
Telephone Number	:	913-588-3304
Fax Number	:	913-588-3365

Provider Business Practice Location Address
First Line	:	KUMC 3901 RAINBOW BLVD MS 1034
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-0001
Country	:	US
Telephone Number	:	913-588-3304
Fax Number	:	913-588-3365

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

Provider Enumeration Date	:	04/02/2022
Last Update Date	:	05/12/2026

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