MEDICARE: DR. RITA DEATTREA BECKFORD 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	207Q00000X	Family Medicine Physician	35-076968	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00403158	OTHER		RAILROAD MEDICARE

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
2	34-1898545	OTHER	OH	TAX ID

General Provider Information

NPI Number	:	1538127360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RITA DEATTREA BECKFORD M.D.

Provider Business Mailing Address
First Line	:	2200 MENELAUS RD
Second Line	:
City	:	BEREA
State	:	KY
Zip	:	40403-9748
Country	:	US
Telephone Number	:	859-228-1565
Fax Number	:	859-228-1567

Provider Business Practice Location Address
First Line	:	2200 MENELAUS RD
Second Line	:
City	:	BEREA
State	:	KY
Zip	:	40403-9748
Country	:	US
Telephone Number	:	859-228-1565
Fax Number	:	859-228-1567

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

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	09/15/2025

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Directions to “ DR. RITA DEATTREA BECKFORD M.D.” Practice Location

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