Healthcare Provider Details

I. General information

NPI: 1891114260
Provider Name (Legal Business Name): NICHOLAS ALAN BECKMANN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2014
Last Update Date: 10/21/2020
Certification Date: 10/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 N CIRCLE DR STE 300
COLORADO SPRINGS CO
80909-1180
US

IV. Provider business mailing address

3030 N CIRCLE DR STE 300
COLORADO SPRINGS CO
80909-1180
US

V. Phone/Fax

Practice location:
  • Phone: 719-867-7800
  • Fax:
Mailing address:
  • Phone: 719-867-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberDR.0063482
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: