Beaird, Jack Gray

Beaird, Jack Gray is an individual health care provider with primary practice located at 407 W 66Th St , Richfield MN 55423-2374. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as his primary health care specialty. Beaird, Jack Gray can be contacted via phone (612) 798-8800.

Contact Information

Primary practice address
407 W 66Th St Richfield MN 55423-2374
Phone: (612) 798-8800
Fax: (612) 798-8816
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 21323 Minnesota

Profile Details

NPI number 1407810286
LBN Legal business name Beaird, Jack Gray
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 17th, 2006
Last updated Nov 6th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407810286 NPPES
Minnesota MEDICAID 194380400

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