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NPI Code Detail

MEDICARE: ELMORE JAMES BECKER JR. MD

MEDICARE: ELMORE JAMES BECKER JR. MD
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
1208800000XUrology Physician0101048894VA

General Provider Information

NPI Number : 1396791372
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELMORE JAMES BECKER JR. MD
Provider Business Mailing Address
First Line : 1051 CARE WAY
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22401-8425
Country : US
Telephone Number : 540-374-3131
Fax Number : 540-374-3134
Provider Business Practice Location Address
First Line : 1051 CARE WAY
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22401-8425
Country : US
Telephone Number : 540-374-3131
Fax Number : 540-374-3134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2006
Last Update Date : 11/29/2011

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