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General NPI Number Information
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NPI Number | 1447678586
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Entity Type | Individual
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Provider Name | JARED BECK D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/05/2014
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Last Update Date | 08/15/2023
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Provider Practice Location Address
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Address Line | 2490 S WOODWORTH LOOP STE 200
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City | PALMER
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State | AK
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Zip | 99645-7410
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Country | US
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Telephone | 907-861-6315
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Fax | 907-861-6533
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Provider Business Mailing Address
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Address Line | PO BOX 689022
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City | FRANKLIN
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State | TN
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Zip | 37068-9022
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Country | US
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Telephone | 615-465-7211
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 1579
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 190145
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License Number State | AK
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