Provider Demographics
NPI:1467457507
Name:BEELER, HENRY S (MD)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:S
Last Name:BEELER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1705 MAIN AVE SW
Mailing Address - Street 2:SUITE B
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-7206
Mailing Address - Country:US
Mailing Address - Phone:256-739-0455
Mailing Address - Fax:256-739-2706
Practice Address - Street 1:1705 MAIN AVE SW
Practice Address - Street 2:SUITE B
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-7206
Practice Address - Country:US
Practice Address - Phone:256-739-0455
Practice Address - Fax:256-739-2706
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00006477207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000000361Medicaid
AL510-00361OtherBCBS
AL000000361Medicaid
AL000000361Medicaid