Healthcare Provider Details

I. General information

NPI: 1720182447
Provider Name (Legal Business Name): ERIC G BECKER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 09/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3715 DAUPHIN ST STE 7A
MOBILE AL
36608-1775
US

IV. Provider business mailing address

3715 DAUPHIN ST STE 7A
MOBILE AL
36608-1775
US

V. Phone/Fax

Practice location:
  • Phone: 251-410-4001
  • Fax: 251-410-4002
Mailing address:
  • Phone: 251-410-4001
  • Fax: 251-410-4002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number420
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: