Provider Demographics
NPI:1922827757
Name:BECKETT, MD, INC.
Entity type:Organization
Organization Name:BECKETT, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BECKETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-326-0129
Mailing Address - Street 1:450 N ROXBURY DR FL 3
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4238
Mailing Address - Country:US
Mailing Address - Phone:310-776-3688
Mailing Address - Fax:
Practice Address - Street 1:450 N ROXBURY DR FL 3
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4238
Practice Address - Country:US
Practice Address - Phone:310-776-3688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty