Provider Demographics
NPI:1417004979
Name:BECKINGHAM, DAVID CLIVE (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CLIVE
Last Name:BECKINGHAM
Suffix:
Gender:M
Credentials:DC
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 133
Mailing Address - Street 2:
Mailing Address - City:IPSWICH
Mailing Address - State:MA
Mailing Address - Zip Code:01938-0133
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:64 COUNTY RD
Practice Address - Street 2:
Practice Address - City:IPSWICH
Practice Address - State:MA
Practice Address - Zip Code:01938-0133
Practice Address - Country:US
Practice Address - Phone:978-356-3979
Practice Address - Fax:978-356-5792
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA537111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1604449OtherMASS HEALTH
MA0474411OtherAETNA HMO
MA734315OtherTUFTS
MABEY35357OtherBLUE CROSS BLUE SHIELD
MA1685152-001OtherCIGNA
MA734315OtherTUFTS
MABEY35357OtherBLUE CROSS BLUE SHIELD