Basic Information
| Provider Information | |||||||||
| NPI: | 1194730689 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BEATTY | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 730 W HAMPDEN AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | ENGLEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801102129 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037620900 | ||||||||
| FaxNumber: | 3037621744 | ||||||||
| Practice Location | |||||||||
| Address1: | 730 W HAMPDEN AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | ENGLEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801102129 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037620900 | ||||||||
| FaxNumber: | 3037621744 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QA0505X | 28419 | CO | X | Allopathic & Osteopathic Physicians | Family Medicine | Adult Medicine | 2083P0500X | 28419 | CO | X | Allopathic & Osteopathic Physicians | Preventive Medicine | Preventive Medicine/Occupational Environmental Medicine | 209800000X | 281419 | CO | X | Allopathic & Osteopathic Physicians | Legal Medicine |
No ID Information.