Provider Demographics
NPI:1457329815
Name:BEAL, JOHN MARTIN (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MARTIN
Last Name:BEAL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2000 S WHEELING AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5647
Mailing Address - Country:US
Mailing Address - Phone:918-747-9641
Mailing Address - Fax:918-749-7806
Practice Address - Street 1:2000 S WHEELING AVE STE 800
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5647
Practice Address - Country:US
Practice Address - Phone:918-747-9641
Practice Address - Fax:918-749-7806
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3176207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100103180CMedicaid
OKF88968Medicare UPIN