Provider Demographics
NPI:1154307064
Name:BEATTY, BARBARA A (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:BEATTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 PLEASANT ST
Mailing Address - Street 2:SUITE 405
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1414
Mailing Address - Country:US
Mailing Address - Phone:515-243-8842
Mailing Address - Fax:515-282-9806
Practice Address - Street 1:1212 PLEASANT ST
Practice Address - Street 2:SUITE 405
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1414
Practice Address - Country:US
Practice Address - Phone:515-243-8842
Practice Address - Fax:515-282-9806
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA23193207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1228494Medicaid
IA2228494Medicaid
A02724Medicare UPIN
IA1228494Medicaid