Beasley, William Thomas

Beasley, William Thomas is an individual health care provider with primary practice located at 4602 Southern Pkwy , Louisville KY 40214-1442. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Beasley, William Thomas can be contacted via phone (502) 366-1479.

Contact Information

Primary practice address
4602 Southern Pkwy Louisville KY 40214-1442
Phone: (502) 366-1479
Fax: (502) 366-6718
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 126 Kentucky
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 07000339A Indiana

Profile Details

NPI number 1336140482
LBN Legal business name Beasley, William Thomas
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2005
Last updated Feb 4th, 2013 - about 12 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 1336140482 NPPES
Other 1054679 PASSPORT
MEDICAID 100075860 PASSPORT
MEDICAID 90125568 PASSPORT
MEDICAID 80001266 PASSPORT

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