Provider Demographics
NPI:1225412885
Name:BEAL, BROOKS (DO)
Entity Type:Individual
Prefix:DR
First Name:BROOKS
Middle Name:
Last Name:BEAL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1841 E RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-7046
Mailing Address - Country:US
Mailing Address - Phone:435-256-8890
Mailing Address - Fax:833-907-2388
Practice Address - Street 1:1841 E RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790
Practice Address - Country:US
Practice Address - Phone:435-256-8890
Practice Address - Fax:833-907-2388
Is Sole Proprietor?:No
Enumeration Date:2015-07-14
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015020862207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine