Provider Demographics
NPI:1427037795
Name:BEATY, ROY DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:DAVID
Last Name:BEATY
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:PO BOX 27877
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0877
Mailing Address - Country:US
Mailing Address - Phone:828-694-8350
Mailing Address - Fax:828-694-7654
Practice Address - Street 1:512 6TH AVE W
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-3558
Practice Address - Country:US
Practice Address - Phone:828-692-0897
Practice Address - Fax:828-692-2146
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA038176174400000X
NC2008-00847207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC150UPOtherBC/BS OF NC
NC5910363Medicaid
NCP00967159OtherRR MEDICARE
GA00702303AMedicaid
GA00702303AMedicaid
NC2023082Medicare PIN