Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 5101014627 | MI |
N | 207RH0003X | Hematology & Oncology | 5101014627 | MI |
NPI | 1578500542 |
---|---|
Provider Name | Dr. Jason Richard Beckrow |
First Address | Saint Joseph, MI 49085-3421 |
Second Address | Saint Joseph, MI 49085-3421 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 25/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5461172 | (05) | MI |
H61469 | (02) | MI |