Healthcare Provider Details

I. General information

NPI: 1659373199
Provider Name (Legal Business Name): JOHN BECK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 08/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 N SAINT JOSEPH AVE
HASTINGS NE
68901-4451
US

IV. Provider business mailing address

715 N SAINT JOSEPH AVE
HASTINGS NE
68901-4451
US

V. Phone/Fax

Practice location:
  • Phone: 402-463-4521
  • Fax:
Mailing address:
  • Phone: 402-463-4521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number18919
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: