MEDICARE: DR. TIFFANY BECKMAN M.D., M.P.H.

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	207R00000X	Internal Medicine Physician	41570	MN
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	41570	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174528939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIFFANY BECKMAN M.D., M.P.H.

Provider Business Mailing Address
First Line	:	425 7TH ST NW
Second Line	:
City	:	CASS LAKE
State	:	MN
Zip	:	56633-3360
Country	:	US
Telephone Number	:	218-335-3200
Fax Number	:	218-335-3284

Provider Business Practice Location Address
First Line	:	425 7TH ST NW
Second Line	:
City	:	CASS LAKE
State	:	MN
Zip	:	56633-5663
Country	:	US
Telephone Number	:	218-335-3200
Fax Number	:	218-335-3284

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	09/30/2022

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