Ethel S Beasley, MD is a
Internal Medicine physician based in Choctaw, Mississippi. Ethel S Beasley is licensed to practice in Mississippi (license number 12703) and her current practice location is 210 Hospital Cir, Choctaw, Mississippi. She can be reached at her office (for appointments etc.) via phone at
(601) 656-2211.
NPI number for Ethel S Beasley is 1154321354 and her current mailing address is 210 Hospital Cir, Choctaw, Mississippi. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1154321354.
Physician's Profile
| Full Name | Ethel S Beasley |
|---|
| Gender | Female |
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| Speciality | Internal Medicine |
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| Location | 210 Hospital Cir, Choctaw, Mississippi |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1154321354
- Provider Enumeration Date: 07/28/2005
- Last Update Date: 09/02/2014
Medical Identifiers
Medical identifiers for Ethel S Beasley such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1154321354 | NPI | - | NPPES |
| 73014344 | Other | | BLUE CROSS OF AL |
| 00111151 | Medicaid | MS | |
| 009974375 | Other | AL | MEDICAID OF AL |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | 12703 (Mississippi) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ethel S Beasley is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ethel S Beasley, MD
210 Hospital Cir,
Choctaw, MS 39350-6781
Ph: (601) 656-2211 | Ethel S Beasley, MD
210 Hospital Cir,
Choctaw, MS 39350-6781
Ph: (601) 656-2211 |
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