Healthcare Provider Details

I. General information

NPI: 1205078896
Provider Name (Legal Business Name): JEFFREY CHANDLER BECK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2009
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2890 1/2 PLEASANT RIDGE CT
BETTENDORF IA
52722-6800
US

IV. Provider business mailing address

2890 1/2 PLEASANT RIDGE CT
BETTENDORF IA
52722-6800
US

V. Phone/Fax

Practice location:
  • Phone: 563-232-5511
  • Fax:
Mailing address:
  • Phone: 563-232-5511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberMD49633
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD49633
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD49633
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: