Provider Demographics
NPI:1487629317
Name:BECKEL, RONALD WILLIAM JR (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:WILLIAM
Last Name:BECKEL
Suffix:JR
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 1:1102 CRESTWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:MENA
Mailing Address - State:AR
Mailing Address - Zip Code:71953-5513
Mailing Address - Country:US
Mailing Address - Phone:479-394-7301
Mailing Address - Fax:479-394-7160
Practice Address - Street 1:1102 CRESTWOOD CIR
Practice Address - Street 2:
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953-5513
Practice Address - Country:US
Practice Address - Phone:479-394-7301
Practice Address - Fax:479-394-7160
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-0796208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR390979OtherHEALTHLINK
AR5K150OtherBCBS PROVIDER #
100186060 AOtherOKLAHOMA HEALTH CARE AUTHORITY
ARP03700OtherNOVASYS
AR129708001Medicaid
AR390979OtherHEALTHLINK
AR5K150OtherBCBS PROVIDER #