Beardsley, Shannon L

Beardsley, Shannon L is an individual health care provider with primary practice located at 3599 University Blvd S Building 300, Jacksonville FL 32216-4252. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Beardsley, Shannon L can be contacted via phone (904) 399-5550.

Contact Information

Primary practice address
3599 University Blvd S Building 300 Jacksonville FL 32216-4252
Phone: (904) 399-5550
Fax: (904) 346-4334
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X ME70257 Florida

Profile Details

NPI number 1649292954
LBN Legal business name Beardsley, Shannon L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 24th, 2006
Last updated Aug 21st, 2017 - about 7 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 1649292954 NPPES
Florida MEDICAID 269418200
Florida MEDICAID 248029216A
Florida Other 37861

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