Provider Demographics
NPI:1336107275
Name:BECKFORD, IAN G (MD)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:G
Last Name:BECKFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:303 PEACHTREE ST NE
Mailing Address - Street 2:SUITE LL-140
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-3201
Mailing Address - Country:US
Mailing Address - Phone:404-813-0976
Mailing Address - Fax:404-813-0997
Practice Address - Street 1:303 PEACHTREE ST NE
Practice Address - Street 2:SUITE LL-140
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-3201
Practice Address - Country:US
Practice Address - Phone:404-813-0976
Practice Address - Fax:404-813-0997
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2016-06-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35.077216207Q00000X
GA073188207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH35211Medicare UPIN
GAH35211Medicare UPIN