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NPI Code Detail

MEDICARE: BECKETT SPRINGS PHYSICIAN GROUP LLC

MEDICARE: BECKETT SPRINGS PHYSICIAN GROUP LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner
22084P0800XPsychiatry Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285045922
Entity Type Code : Organization
Provider Name (Legal Business Name) : BECKETT SPRINGS PHYSICIAN GROUP LLC
Provider Business Mailing Address
First Line : 8614 SHEPHERD FARM DR
Second Line :
City : WEST CHESTER
State : OH
Zip : 45069-1128
Country : US
Telephone Number : 513-942-9500
Fax Number : 513-714-7374
Provider Business Practice Location Address
First Line : 8614 SHEPHERD FARM DR
Second Line :
City : WEST CHESTER
State : OH
Zip : 45069-1128
Country : US
Telephone Number : 513-942-9500
Fax Number : 513-714-7374
Authorized Official
Title or Position : DIRECTOR CREDENTIALING & PAYOR ENRO
Name : GINA WARREN
Credential :
Telephone Number : 502-400-8480
Provider Enumeration Date : 05/15/2014
Last Update Date : 10/11/2021

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Directions to “BECKETT SPRINGS PHYSICIAN GROUP LLC ” Practice Location

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