Provider Demographics
NPI:1366494783
Name:BECKMANN, JOSEPH ALBERT (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ALBERT
Last Name:BECKMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:2325 SMILEY LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65202-1947
Practice Address - Country:US
Practice Address - Phone:573-884-8980
Practice Address - Fax:573-884-0040
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMDR8J16207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO104080OtherUNITED HEALTHCARE
MO203015318Medicaid
MO22732OtherBLUE SHIELD
MO142290OtherHEALTHLINK
MO22732OtherBLUE CHOICE
MO2086350401OtherKANSAS MEDICAID
MOP00422530Medicare UPIN
MO080126167Medicare UPIN
MO001012949Medicare PIN
MO22732OtherBLUE CHOICE
MO142290OtherHEALTHLINK