Provider Demographics
NPI:1154310308
Name:BEYER, LEE G (MD, MPH/TM)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:G
Last Name:BEYER
Suffix:
Gender:M
Credentials:MD, MPH/TM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:267 E EAGLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH SALT LAKE
Mailing Address - State:UT
Mailing Address - Zip Code:84054-2584
Mailing Address - Country:US
Mailing Address - Phone:801-936-1366
Mailing Address - Fax:
Practice Address - Street 1:7321 11TH ST
Practice Address - Street 2:75MDG/SGP, BLDG 569
Practice Address - City:HILL AFB
Practice Address - State:UT
Practice Address - Zip Code:84056-5012
Practice Address - Country:US
Practice Address - Phone:801-777-4710
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010493512083A0100X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
Not Answered2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine