Provider Demographics
NPI:1184668667
Name:BEASLEY, RALPH DONALD (MD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:DONALD
Last Name:BEASLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:DHMC. DEPARTMENT OF ANESTHESIA
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-1000
Mailing Address - Country:US
Mailing Address - Phone:603-650-6040
Mailing Address - Fax:603-650-8199
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:DHMC. DEPARTMENT OF ANESTHESIA
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-650-6040
Practice Address - Fax:603-650-8199
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH6008207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH81050418Medicaid
VT0RE0359Medicaid
E11760Medicare UPIN
VT0RE0359Medicaid
VTVN2870Medicare PIN