Healthcare Provider Details

I. General information

NPI: 1407850340
Provider Name (Legal Business Name): JEFFREY P BECKENBAUGH DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 E RIVER RD
TUCSON AZ
85718-5831
US

IV. Provider business mailing address

1501 N. CAMPBELL AVENUE TOWER 4 - ROOM 8401
TUCSON AZ
85724
US

V. Phone/Fax

Practice location:
  • Phone: 520-321-9850
  • Fax: 520-321-9005
Mailing address:
  • Phone: 520-626-4024
  • Fax: 520-626-2668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number009119
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: