MEDICARE: MR. THOMAS A BECKETT M.D

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
1	207V00000X	Obstetrics & Gynecology Physician	ME0058884	FL
2	207V00000X	Obstetrics & Gynecology Physician	ME58884	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1326035452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THOMAS A BECKETT M.D

Provider Business Mailing Address
First Line	:	1865 VETERANS PARK DR
Second Line	:	SUITE 201
City	:	NAPLES
State	:	FL
Zip	:	34109-0447
Country	:	US
Telephone Number	:	239-514-3131
Fax Number	:	239-572-6101

Provider Business Practice Location Address
First Line	:	1865 VETERANS PARK DR
Second Line	:	SUITE 201
City	:	NAPLES
State	:	FL
Zip	:	34109-0447
Country	:	US
Telephone Number	:	239-514-3131
Fax Number	:	239-572-6101

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	07/10/2023

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