MEDICARE: MR. MICHAEL R BECKEL PA-C

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	363A00000X	Physician Assistant	100	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0000095633	OTHER	MT	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477592236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL R BECKEL PA-C

Provider Business Mailing Address
First Line	:	2425 BIG FLAT RD
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59804-9466
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	900 N ORANGE ST STE 106
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59802-2951
Country	:	US
Telephone Number	:	406-327-3100
Fax Number	:	406-327-3141

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

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	05/04/2020

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