Richard R Beesley, MD

Individual provider Active NPI Pediatrics Physician · Estes Park, CO

NPI 1790770295 · NPPES record last updated Apr 21, 2011

Key facts

NPI
1790770295
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
40219 (CO)
Practice address
555 Prospect Ave
Estes Park, CO 80517-6312
Phone
(970) 586-2200
Fax
(970) 586-9096
NPI assigned
Sep 12, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
40219COMDPediatrics Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 40219 CO Yes

Addresses

Primary practice location

555 Prospect Ave
Estes Park, CO 80517-6312

Mailing address

555 Prospect Ave
Estes Park, CO 80517-6312
Phone (970) 586-2200

Other identifiers

IdentifierTypeStateIssuer
27831761MedicaidCO

Other providers in Estes Park, CO

All providers in Estes Park, CO · Pediatrics Physician in Colorado

Sources for this page

Verify at the official NPI Registry.