Blake Richard Beazer in Tooele - Family Medicine
Blake Richard Beazer - NPI 1073510012
Blake Richard Beazer is a Family Medicine in Tooele, Utah. Blake Richard Beazer practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Blake Richard Beazer is 1073510012. The last update date is 2014-03-21.
Blake Richard Beazer's current location address is 2356 N 400 E, Tooele, Utah. You can contact this provider via phone number 4358822350 and fax number 4358822039. The mailing address for Blake Richard Beazer is 2356 N 400 E, Tooele, Utah. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Blake Richard Beazer |
|---|---|
| Address | 2356 N 400 E, Tooele, Utah |
| Phone Number | 4358822350 |
| Fax Number | 4358822039 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1073510012 |
|---|---|
| Provider Enumeration Date | 2005-07-06 |
| Last Updated Date | 2014-03-21 |
Provider Mailing Address Detail
| Address | 2356 N 400 E |
|---|---|
| City | Tooele |
| State | Utah (UT) |
| Post Code | 84074 |
| Phone Number | 4358822350 |
| Fax Number | 4358822039 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | 5248080-1205 |
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Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| D4916 | UT | -- |
Post Comment/ Review Below
What is the unique identification code assigned to Blake Richard Beazer by the Centers for Medicare & Medicaid Services?
The Blake Richard Beazer has been issued the NPI (National Provider Identifier) 1073510012. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Blake Richard Beazer is physically located?
The Blake Richard Beazer is situated at the following address: 2356 N 400 E, Tooele, UT 84074.
What is Blake Richard Beazer's area of expertise and its corresponding taxonomy classification?
The Blake Richard Beazer's field of specialization is Family Medicine, and it falls under the taxonomy code 207Q00000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services assign the 1073510012 to Blake Richard Beazer?
The Centers for Medicare & Medicaid Services assigned the 1073510012 to Blake Richard Beazer on 2005-07-06.
When was the information regarding Blake Richard Beazer most recently updated?
The details pertaining to the Blake Richard Beazer, including its address, specialty, and other relevant information, were last refreshed on 2014-03-21.