MEDICARE: DR. JARRETTE ALLEN BECK JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QA0505X	Adult Medicine Physician	31329	CO

General Provider Information

NPI Number	:	1134256233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JARRETTE ALLEN BECK JR. M.D.

Provider Business Mailing Address
First Line	:	PO BOX 935
Second Line	:	721 WHITE ROCK AVE.
City	:	CRESTED BUTTE
State	:	CO
Zip	:	81224-0935
Country	:	US
Telephone Number	:	970-209-5070
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 BLANCA AVE
Second Line	:	SIERRA BLANCA MEDICAL CLINIC
City	:	ALAMOSA
State	:	CO
Zip	:	81101-2340
Country	:	US
Telephone Number	:	719-589-3658
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	11/23/2007

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