Nolan Jackson Beavers, M.D, Valid NPI

Individual provider · Family Medicine Physician · Belleville, KS

NPI

1104921782

Type

Individual (Type 1)

Primary specialty

Family Medicine Physician (Family Medicine)

Specialty group

Allopathic & Osteopathic Physicians

Taxonomy code

207Q00000X

License number

04-30225 (KS)

Sex

Male

Sole proprietor

Yes

Enumerated

2006-09-14

Last updated

2009-01-23