Provider Demographics
NPI:1497142103
Name:BECK, SALAH ROXANNE (DO)
Entity Type:Individual
Prefix:MS
First Name:SALAH
Middle Name:ROXANNE
Last Name:BECK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1721 EDGEMONT DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-2545
Mailing Address - Country:US
Mailing Address - Phone:256-436-6355
Mailing Address - Fax:
Practice Address - Street 1:1215 7TH ST SE STE 240
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-3397
Practice Address - Country:US
Practice Address - Phone:256-335-9216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-20
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ALDO.1972207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program