Provider Demographics
NPI:1861659567
Name:BEASLEY, GEORGIA (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGIA
Middle Name:
Last Name:BEASLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GEORGIA
Other - Middle Name:
Other - Last Name:BEASLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3812 STONEYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2400
Mailing Address - Country:US
Mailing Address - Phone:919-812-4397
Mailing Address - Fax:919-419-8810
Practice Address - Street 1:3812 STONEYBROOK DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2400
Practice Address - Country:US
Practice Address - Phone:919-812-4397
Practice Address - Fax:919-419-8810
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program