Provider Demographics
NPI:1043786064
Name:BECKHAM, HANDY III
Entity Type:Individual
Prefix:
First Name:HANDY
Middle Name:
Last Name:BECKHAM
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5425 GALERIA DR STE C
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-8004
Mailing Address - Country:US
Mailing Address - Phone:225-223-6153
Mailing Address - Fax:
Practice Address - Street 1:5425 GALERIA DR.
Practice Address - Street 2:STE. C
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-7081
Practice Address - Country:US
Practice Address - Phone:225-223-6153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-17
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator