MEDICARE: ERIN MIKEL HAY BECKERMAN DO

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	207Q00000X	Family Medicine Physician	47256	CO

General Provider Information

NPI Number	:	1689838070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN MIKEL HAY BECKERMAN DO

Provider Business Mailing Address
First Line	:	108 S FRONTAGE RD W
Second Line	:	STE 101
City	:	VAIL
State	:	CO
Zip	:	81657-5087
Country	:	US
Telephone Number	:	970-926-6340
Fax Number	:	970-926-6348

Provider Business Practice Location Address
First Line	:	400 N PARK AVE
Second Line	:	SUITE 1A
City	:	BRECKENRIDGE
State	:	CO
Zip	:	80424-8850
Country	:	US
Telephone Number	:	970-547-9200
Fax Number	:	970-262-2196

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

Provider Enumeration Date	:	07/15/2008
Last Update Date	:	08/05/2020

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