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General NPI Number Information
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NPI Number | 1295182442
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Entity Type | Individual
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Provider Name | JASON MARK BECKTA M.D., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 05/18/2016
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Last Update Date | 12/23/2023
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Provider Practice Location Address
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Address Line | 160 ALLEN ST
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City | RUTLAND
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State | VT
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Zip | 05701-4560
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Country | US
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Telephone | 802-747-1831
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Fax |
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Provider Business Mailing Address
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Address Line | 3035 ROUTE 50 # 1042
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-2900
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Country | US
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Telephone | 518-650-1851
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Fax |
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 308237-01
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 042-0016454
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License Number State | VT
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