Blake R. Beazer, M.D., Inc

LBN: Blake R. Beazer, M.D., Inc
Blake R. Beazer, M.D., Inc is an health care organization with primary practice located at 2356 N 400 E Ste. 201, Tooele UT 84074-3409. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Blake R. Beazer, M.D., Inc can be contacted via phone (435) 882-2350, or through Beazer, Blake Richard via phone (435) 882-2358.

Contact Information

Primary practice address
2356 N 400 E Ste. 201 Tooele UT 84074-3409
Phone: (435) 882-2350
Fax: (435) 882-2039
Website:
Map and Directions
Authorized official contact:
Name: Beazer, Blake Richard Doctor of Medicine (MD)
Phone: (435) 882-2358

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 52480801205 Utah

Profile Details

NPI number 1184807992
LBN Legal business name Blake R. Beazer, M.D., Inc
DBA Doing business as
Authorized official Beazer, Blake Richard Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 14th, 2007
Last updated Jan 10th, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184807992 NPPES
Utah Other 000057289 MEDICARE PTAN

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