Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 060703 | GA |
N | 207VG0400X | Gynecologist | 244284 | NY |
NPI | 1003017526 |
---|---|
Provider Name | Tanya Denise Beckford |
First Address | Fayetteville, GA 30214-4550 |
Second Address | Fayetteville, GA 30214-4550 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2007 |
Last Update Date | 06/06/2014 |