Provider Demographics
NPI:1497753016
Name:BECKMAN, DEAN E (MD)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:E
Last Name:BECKMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 SAINT CHARLES ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-9172
Mailing Address - Country:US
Mailing Address - Phone:812-482-9555
Mailing Address - Fax:812-482-9073
Practice Address - Street 1:1950 SAINT CHARLES ST
Practice Address - Street 2:SUITE 4
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-9172
Practice Address - Country:US
Practice Address - Phone:812-482-9555
Practice Address - Fax:812-482-9073
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01038345A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100098840AMedicaid
E34629Medicare UPIN
IN100098840AMedicaid