Provider Demographics
NPI:1447200142
Name:BECKMAN, ALAN JALMAR (OD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:JALMAR
Last Name:BECKMAN
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 1:195 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-7495
Mailing Address - Country:US
Mailing Address - Phone:406-257-1281
Mailing Address - Fax:
Practice Address - Street 1:195 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-7495
Practice Address - Country:US
Practice Address - Phone:406-257-1281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT566152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT483860BMedicaid
MTU39740Medicare UPIN