Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 39505 | CO |
NPI | 1184634925 |
---|---|
Provider Name | Dr. Jeffrey Scott Beckman |
First Address | Golden, CO 80401-8016 |
Second Address | Wheat Ridge, CO 80033-6005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 17/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
53105231 | (05) | CO |
H65631 | (02) |