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John Wesley Beal

Internal Medicine

Allopathic & Osteopathic Physicians

200 E Chestnut St Bldg Suite303, Louisville, KY 40202-1831

PECOS Enrollment

This provider is enrolled in PECOS as JOHN BEAL.

Based on the most recent information from CMS, provider John Wesley Beal is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:47 AM.

Profile Details

Provider ID
1558725838
Provider Type
Individual
Full Name
Beal, John Wesley
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
4/12/2016
Last Updated
3/18/2021

Contact Information

Practice Location

200 E Chestnut St Bldg Suite303, Louisville, KY 40202-1831

(502) 629-5552

(502) 629-3132

Mailing Location

PO Box 776351, Chicago, IL 60677-6351

(502) 272-5395

(502) 272-5339

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 52451 Kentucky
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

John Wesley Beal

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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