Provider Demographics
NPI:1700291903
Name:BEASLEY, JENNIFER LEAH NEIGHBORS (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEAH NEIGHBORS
Last Name:BEASLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 JONES DAIRY RD
Mailing Address - Street 2:BLDG 600
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-6106
Mailing Address - Country:US
Mailing Address - Phone:205-295-4100
Mailing Address - Fax:205-295-4101
Practice Address - Street 1:1450 JONES DAIRY RD STE 500
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501
Practice Address - Country:US
Practice Address - Phone:205-295-4290
Practice Address - Fax:205-221-9058
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL35954207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine