Beasley, Glenn A.

Beasley, Glenn A. is an sole proprietor health care provider with primary practice located at 2158 Northgate Park Ln Suite 104, Chattanooga TN 37415-6957. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Beasley, Glenn A. can be contacted via phone (423) 870-2030.

Contact Information

Primary practice address
2158 Northgate Park Ln Suite 104 Chattanooga TN 37415-6957
Phone: (423) 870-2030
Fax: (423) 875-6405
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X MD0000020673 Tennessee

Profile Details

NPI number 1023141025
LBN Legal business name Beasley, Glenn A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 13th, 2007
Last updated Mar 13th, 2008 - about 17 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 1023141025 NPPES
Tennessee MEDICAID 3053865

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