Provider Demographics
NPI:1982112793
Name:BEACHY, KEITH (DC)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:
Last Name:BEACHY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15400 CHENAL PARKWAY STE 120
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-2297
Mailing Address - Country:US
Mailing Address - Phone:501-400-7700
Mailing Address - Fax:501-244-3784
Practice Address - Street 1:15400 CHENAL PARKWAY STE 120
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-2297
Practice Address - Country:US
Practice Address - Phone:501-400-7700
Practice Address - Fax:501-244-3784
Is Sole Proprietor?:No
Enumeration Date:2018-01-15
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR16184111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor