MEDICARE: DR. BRADFORD BECKMAN DDS

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	122300000X	Dentist	30022544	OH

General Provider Information

NPI Number	:	1588862783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRADFORD BECKMAN DDS

Provider Business Mailing Address
First Line	:	1179 COLUMBUS PIKE
Second Line	:	STATE ROUTE 23
City	:	DELAWARE
State	:	OH
Zip	:	43015-2713
Country	:	US
Telephone Number	:	740-362-2202
Fax Number	:	740-362-2204

Provider Business Practice Location Address
First Line	:	1179 COLUMBUS PIKE
Second Line	:	STATE ROUTE 23
City	:	DELAWARE
State	:	OH
Zip	:	43015-2713
Country	:	US
Telephone Number	:	740-362-2202
Fax Number	:	740-362-2204

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

Provider Enumeration Date	:	07/10/2007
Last Update Date	:	04/13/2009

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