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General NPI Number Information
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NPI Number | 1164431789
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Entity Type | Individual
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Provider Name | PAUL M BEKKUM DC
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 1402 43RD ST S STE 200
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City | FARGO
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State | ND
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Zip | 58103-7500
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Country | US
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Telephone | 701-356-0016
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Fax | 701-892-7064
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Provider Business Mailing Address
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Address Line | 1402 43RD ST S STE 200
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City | FARGO
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State | ND
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Zip | 58103-7500
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Country | US
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Telephone | 701-356-0016
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Fax | 701-892-7064
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 1378
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 2197
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 788
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License Number State | ND
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