Provider Demographics
NPI:1992061071
Name:BEESTON, PAUL HENRY (DO)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:HENRY
Last Name:BEESTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 E TRADEWIND DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-1027
Mailing Address - Country:US
Mailing Address - Phone:801-318-0085
Mailing Address - Fax:
Practice Address - Street 1:1345 E TRADEWIND DR
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-1027
Practice Address - Country:US
Practice Address - Phone:801-318-0085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2015-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ006499207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine