Provider Demographics
NPI:1003107558
Name:BECKSTEAD, DAVID JUSTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JUSTIN
Last Name:BECKSTEAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:101 COMMERCE PARK DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-8349
Mailing Address - Country:US
Mailing Address - Phone:614-898-3006
Mailing Address - Fax:614-898-3023
Practice Address - Street 1:101 COMMERCE PARK DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-8349
Practice Address - Country:US
Practice Address - Phone:614-898-3006
Practice Address - Fax:614-898-3023
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-02
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8859872-1205207Q00000X
OH35.120353207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine