MEDICARE: DR. JAMES BRADLEY BECKHAM M.S., 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	208600000X	Surgery Physician	25127	MS

General Provider Information

NPI Number	:	1598029969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES BRADLEY BECKHAM M.S., M.D.

Provider Business Mailing Address
First Line	:	965 RIDGE LAKE BLVD STE 103
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38120-9446
Country	:	US
Telephone Number	:
Fax Number	:	901-227-8591

Provider Business Practice Location Address
First Line	:	255 BAPTIST BLVD STE 307
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39705-2006
Country	:	US
Telephone Number	:	662-328-1862
Fax Number	:	662-328-7597

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

Provider Enumeration Date	:	06/29/2012
Last Update Date	:	09/11/2020

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