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NPI 1871622845

NPI 1871622845 : KENNETH ROBERT BECK OD : WASHINGTON, DC

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General NPI Number Information
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    NPI Number           |    1871622845
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    Entity Type          |    Individual 
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    Provider Name        |    KENNETH ROBERT BECK OD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/05/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    1747 PENNSYLVANIA AVE NW 
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    City                 |    WASHINGTON
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    State                |    DC
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    Zip                  |    20006-4604
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    Country              |    US
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    Telephone            |    202-466-2050
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3525 WHITE LN 
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    City                 |    SARASOTA
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    State                |    FL
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    Zip                  |    34242-1055
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    Country              |    US
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    Telephone            |    941-807-4876
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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        |    152W00000X
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    Taxonomy Name        |    Optometrist
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    License Number       |    OP764
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    License Number State |    DC
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