Provider Demographics
NPI:1467520684
Name:BECK, JR., WILLIAM WOOLVERTON (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:WOOLVERTON
Last Name:BECK, JR.
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:855 HAWK DR
Mailing Address - Street 2:
Mailing Address - City:POLSON
Mailing Address - State:MT
Mailing Address - Zip Code:59860-8919
Mailing Address - Country:US
Mailing Address - Phone:406-883-2295
Mailing Address - Fax:406-883-2295
Practice Address - Street 1:855 HAWK DR
Practice Address - Street 2:
Practice Address - City:POLSON
Practice Address - State:MT
Practice Address - Zip Code:59860-8919
Practice Address - Country:US
Practice Address - Phone:406-883-2295
Practice Address - Fax:406-883-2295
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT9911207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTC27342Medicare UPIN