Healthcare Provider Details

I. General information

NPI: 1184634925
Provider Name (Legal Business Name): JEFFREY SCOTT BECKMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 10/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 W 38TH AVE
WHEAT RIDGE CO
80033-6005
US

IV. Provider business mailing address

2074 FOOTHILLS DR S
GOLDEN CO
80401-8016
US

V. Phone/Fax

Practice location:
  • Phone: 303-425-2087
  • Fax:
Mailing address:
  • Phone: 303-526-7538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number39505
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier53105231
Identifier TypeMEDICAID
Identifier StateCO
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: