Basic Information
| Provider Information | |||||||||
| NPI: | 1780675355 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BEEZLEY | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1707 COLE BLVD | ||||||||
| Address2: | STE 100 | ||||||||
| City: | GOLDEN | ||||||||
| State: | CO | ||||||||
| PostalCode: | 804013220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037168013 | ||||||||
| FaxNumber: | 3037635495 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 W COUNTY LINE RD | ||||||||
| Address2: | STE 130 | ||||||||
| City: | HIGHLANDS RANCH | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801292360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037910418 | ||||||||
| FaxNumber: | 3037911849 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2005 | ||||||||
| LastUpdateDate: | 10/04/2013 | ||||||||
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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 | 207Q00000X | 30483 | CO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.