Robert Alan Beasley, MD
Individual provider Active NPI Orthopaedic Surgery Physician · Tullahoma, TN
NPI 1144299587 · NPPES record last updated Jun 21, 2010
Key facts
- NPI
- 1144299587
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- License
- MD011102 (TN)
- Practice address
- 1940 North Jackson Street
Suite 150
Tullahoma, TN 37388 - Phone
- (931) 563-8003
- NPI assigned
- Mar 17, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050228000405 | TN | Practitioner - Orthopedic Surgery | 5597718726 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD011102 | TN | MD | Orthopaedic Surgery Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | MD011102 | TN | Yes |
Addresses
Primary practice location
1940 North Jackson Street
Suite 150
Tullahoma, TN 37388
Mailing address
102 Dunhill Place
Cleveland, TN 37311
Phone (423) 472-1567
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3197792 | Medicaid | TN |
Other providers in Tullahoma, TN
- Eric William Beach
- Regina L Beach
- Joseph Bean
- Lauren Bean
- Linda Deanne Beard
- Edward Lee Beavers
- Laura Beckwith Dotson
- Tamara Shea Belinc
- Angela Sherlin Bell
- Catherine Bell
All providers in Tullahoma, TN · Orthopaedic Surgery Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.