Provider Demographics
NPI:1386642577
Name:BEIGHLE, JOHN K (DPM)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:K
Last Name:BEIGHLE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 FORT MISSOULA RD
Mailing Address - Street 2:STE 106
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59804-7420
Mailing Address - Country:US
Mailing Address - Phone:406-543-5333
Mailing Address - Fax:406-543-5621
Practice Address - Street 1:2825 FORT MISSOULA RD
Practice Address - Street 2:STE 106
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804-7420
Practice Address - Country:US
Practice Address - Phone:406-543-5333
Practice Address - Fax:406-543-5621
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-12
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT113213ES0131X, 213E00000X
MT219938363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000007931OtherBCBS
MT0390422Medicaid
MT000083940Medicare ID - Type Unspecified
MT000007931OtherBCBS