Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | ME82030 | FL |
NPI | 1013210301 |
---|---|
Provider Name | Dr. John Henry Beckett |
First Address | Kansas City, MO 64157-8663 |
Second Address | Kansas City, MO 64157-8663 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2010 |
Last Update Date | 26/03/2014 |