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General NPI Number Information
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NPI Number | 1194163683
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Entity Type | Organization
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Legal Business Name | BECKWITH MEDICAL GROUP, PLLC
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Dates
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Enumeration Date | 06/06/2013
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Last Update Date | 06/06/2013
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Provider Practice Location Address
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Address Line | 952 EDWARDS FERRY RD NE
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City | LEESBURG
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State | VA
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Zip | 20176-3324
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Country | US
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Telephone | 240-379-7776
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Fax | 240-378-7787
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Provider Business Mailing Address
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Address Line | 952 EDWARDS FERRY RD NE
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City | LEESBURG
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State | VA
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Zip | 20176-3324
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Country | US
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Telephone | 240-379-7776
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Fax | 240-379-7787
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. RONALD ROBERT GOLDEN
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Credential | RT
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Telephone | 240-379-7776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State | VA
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