MEDICARE: DR. ANNA C BECK MD

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	207RH0003X	Hematology & Oncology Physician	177465-1205	UT
2	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician	177465-1205	UT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110109730	OTHER	UT	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1710936265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNA C BECK MD

Provider Business Mailing Address
First Line	:	127 SO. 500 EAST #600
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-1971
Country	:	US
Telephone Number	:	801-587-6705
Fax Number	:	801-715-8228

Provider Business Practice Location Address
First Line	:	1950 CIRCLE OF HOPE
Second Line	:	CLINIC 2B
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84112-5500
Country	:	US
Telephone Number	:	801-585-0100
Fax Number	:	801-585-2984

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

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	12/03/2021

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