Provider Demographics
NPI:1851391627
Name:BEAL, PERRY W JR (MD)
Entity Type:Individual
Prefix:
First Name:PERRY
Middle Name:W
Last Name:BEAL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:305 EAST CENTER AVE.
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-6331
Mailing Address - Country:US
Mailing Address - Phone:559-737-4700
Mailing Address - Fax:559-737-4782
Practice Address - Street 1:33025 ROAD 159
Practice Address - Street 2:
Practice Address - City:IVANHOE
Practice Address - State:CA
Practice Address - Zip Code:93235-1234
Practice Address - Country:US
Practice Address - Phone:760-337-1771
Practice Address - Fax:760-337-1122
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG358492083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WG35849BMedicare ID - Type Unspecified
A46500Medicare UPIN
CAA46500Medicare UPIN