Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 57382 | TN |
N | 2080P0202X | Pediatric Cardiologist | 57382 | TN |
NPI | 1669764106 |
---|---|
Provider Name | Gary S Beasley |
First Address | Memphis, TN 38103-2802 |
Second Address | Memphis, TN 38105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2011 |
Last Update Date | 13/07/2018 |