Provider Demographics
NPI:1497819379
Name:BECK, KIMBALL J (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBALL
Middle Name:J
Last Name:BECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1220 12TH ST SE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-3722
Mailing Address - Country:US
Mailing Address - Phone:202-379-5626
Mailing Address - Fax:202-559-6071
Practice Address - Street 1:1901 D ST SE
Practice Address - Street 2:3RD FOOR, MEDICAL UNIT
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-2534
Practice Address - Country:US
Practice Address - Phone:202-698-0437
Practice Address - Fax:202-673-8010
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2011-09-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DCMD31548207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine