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General NPI Number Information
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NPI Number | 1265638712
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Entity Type | Organization
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Legal Business Name | BECKER NEUROLOGICAL INSTITUTE PLLC
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 05/07/2014
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Provider Practice Location Address
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Address Line | 565 CENTRE VIEW BLVD
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City | CRESTVIEW HILLS
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State | KY
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Zip | 41017-3444
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Country | US
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Telephone | 859-341-6387
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Fax | 513-721-1649
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Provider Business Mailing Address
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Address Line | 565 CENTRE VIEW BLVD
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City | CRESTVIEW HILLS
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State | KY
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Zip | 41017-3444
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Country | US
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Telephone | 859-341-6387
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Fax | 513-721-1649
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Authorized Official
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Title or Position | SOLE PROPRIETER
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Name | PHILIP S BECKER
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Credential | MD
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Telephone | 859-341-6387
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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