Provider Demographics
NPI:1598852337
Name:BEESCH, KARL W (MD)
Entity type:Individual
Prefix:
First Name:KARL
Middle Name:W
Last Name:BEESCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 TENTH STREET
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:56187-2343
Mailing Address - Country:US
Mailing Address - Phone:507-372-2921
Mailing Address - Fax:507-372-1815
Practice Address - Street 1:508 TENTH STREET
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:MN
Practice Address - Zip Code:56187-2343
Practice Address - Country:US
Practice Address - Phone:507-372-2921
Practice Address - Fax:507-372-1815
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN29520207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN50M04BEOtherBCBS MPIN
MN108757OtherUCARE
IA562850Medicaid
MN108757OtherUCARE