Provider Demographics
NPI:1912909771
Name:BEEKLEY, WILLIAM H (MD)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:H
Last Name:BEEKLEY
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 854
Mailing Address - Street 2:
Mailing Address - City:BOAZ
Mailing Address - State:AL
Mailing Address - Zip Code:35957-0854
Mailing Address - Country:US
Mailing Address - Phone:256-891-5102
Mailing Address - Fax:256-891-5103
Practice Address - Street 1:11491 US HIGHWAY 431
Practice Address - Street 2:SUITE D
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35950-0137
Practice Address - Country:US
Practice Address - Phone:256-894-6976
Practice Address - Fax:256-894-6979
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00015117174400000X
AL15117174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000021490Medicaid
AL000021490Medicaid
B37275Medicare UPIN