Healthcare Provider Details

I. General information

NPI: 1588667729
Provider Name (Legal Business Name): JEFFREY A BECKER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 09/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9003 E SHEA BLVD
SCOTTSDALE AZ
85260-6709
US

IV. Provider business mailing address

7351 E OSBORN RD
SCOTTSDALE AZ
85251-6451
US

V. Phone/Fax

Practice location:
  • Phone: 480-323-3000
  • Fax:
Mailing address:
  • Phone: 480-882-4335
  • Fax: 480-882-5705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number3180
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: