MEDICARE: JASON ROBERT 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	2085R0202X	Diagnostic Radiology Physician	E4000	AR

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	:	1972546315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON ROBERT BECK M.D.

Provider Business Mailing Address
First Line	:	1115 W 3RD ST
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72201-2007
Country	:	US
Telephone Number	:	501-687-9099
Fax Number	:	501-687-9276

Provider Business Practice Location Address
First Line	:	13107 COLONEL GLENN RD
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72210-2319
Country	:	US
Telephone Number	:	501-425-3537
Fax Number	:	501-687-9276

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

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	01/18/2022

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