MEDICARE: KIMBERLY E BECK 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	94-276640-1205	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1761842	OTHER	UT	FIRST HEALTH INSURANCE
2	870547025 84634 A001	OTHER	UT	TRICARE
3	107007469101	OTHER	UT	INTERMOUNTAIN HEALTH PLAN
4	8997495	OTHER	UT	CIGNA HEALTH PLANS
5	226451	OTHER	UT	DESERT MUTUAL HEALTH BENE
6	870547025BE1	OTHER	UT	EDUCATORS MUTUAL INSURANC
7	QM0000377606	OTHER	UT	ALTIUS HEALTH PLANS

General Provider Information

NPI Number	:	1700814803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY E BECK M.D.

Provider Business Mailing Address
First Line	:	PO BOX 640
Second Line	:
City	:	GUNNISON
State	:	UT
Zip	:	84634-0640
Country	:	US
Telephone Number	:	435-528-7935
Fax Number	:	435-528-7936

Provider Business Practice Location Address
First Line	:	76 EAST CENTER
Second Line	:
City	:	GUNNISON
State	:	UT
Zip	:	84634
Country	:	US
Telephone Number	:	435-528-7935
Fax Number	:	435-528-7938

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	07/09/2007

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Directions to “ KIMBERLY E BECK M.D.” Practice Location

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