Beaty, Jeffory W

Beaty, Jeffory W is an individual health care provider with primary practice located at 700 E Marshall Ave , Longview TX 75601-5580. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Beaty, Jeffory W can be contacted via phone (903) 315-2000.

Contact Information

Primary practice address
700 E Marshall Ave Longview TX 75601-5580
Phone: (903) 315-2000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X K2415 Texas
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X K2415 Texas

Profile Details

NPI number 1194715888
LBN Legal business name Beaty, Jeffory W
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2005
Last updated Jul 7th, 2022 - about 2 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 1194715888 NPPES
Texas MEDICAID 104584101
Texas Other 85X883

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