Healthcare Provider Details

I. General information

NPI: 1811935414
Provider Name (Legal Business Name): ELIZABETH C BECTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 02/08/2024
Certification Date: 02/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 D'ANTIGNAC ST. SUITE 2600
AUGUSTA GA
30901-2796
US

IV. Provider business mailing address

PO BOX 1758
EVANS GA
30809-3089
US

V. Phone/Fax

Practice location:
  • Phone: 706-854-2500
  • Fax: 706-854-2559
Mailing address:
  • Phone: 706-854-2500
  • Fax: 706-854-2559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number038178
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number038178
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: