Provider Demographics
NPI:1205836525
Name:BECK, DANIEL TURNEY (OD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:TURNEY
Last Name:BECK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5615 S NC 41 HWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WALLACE
Mailing Address - State:NC
Mailing Address - Zip Code:28466-6216
Mailing Address - Country:US
Mailing Address - Phone:910-285-5050
Mailing Address - Fax:910-285-2968
Practice Address - Street 1:201 RACINE DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-8702
Practice Address - Country:US
Practice Address - Phone:910-395-6050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1488152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC410048232OtherRR MEDICARE INDIVIDUAL #
NC410032675OtherRR MEDICARE INDIVIDUAL #
NC0904TOtherBCBS PROV #
NC890904TMedicaid
NC2469299CMedicare PIN
NC410032675OtherRR MEDICARE INDIVIDUAL #
NC2469299DMedicare PIN
U45269Medicare UPIN
NC890904TMedicaid
NC2469299Medicare PIN
NC2469299EMedicare PIN