Healthcare Provider Details

I. General information

NPI: 1831173889
Provider Name (Legal Business Name): PAUL ANDREW BECKER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2005
Last Update Date: 12/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3730 RHONE CIR SUITE 203
ANCHORAGE AK
99508-5054
US

IV. Provider business mailing address

3730 RHONE CIR SUITE 203
ANCHORAGE AK
99508-5054
US

V. Phone/Fax

Practice location:
  • Phone: 907-563-3515
  • Fax: 907-563-3541
Mailing address:
  • Phone: 907-563-3515
  • Fax: 907-563-3541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: