Healthcare Provider Details

I. General information

NPI: 1871539627
Provider Name (Legal Business Name): DAVID DUANE BECK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 12/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11700 W 2ND PL MEDICAL PLAZA 2, STE. 210
LAKEWOOD CO
80228-1704
US

IV. Provider business mailing address

11700 W 2ND PL MEDICAL PLAZA 2, STE. 210
LAKEWOOD CO
80228-1704
US

V. Phone/Fax

Practice location:
  • Phone: 720-321-8080
  • Fax: 720-321-8081
Mailing address:
  • Phone: 720-321-8080
  • Fax: 720-321-8081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number42574
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0431601
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: