Provider Demographics
NPI:1508128216
Name:BECK, JAMES STEPHEN
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:STEPHEN
Last Name:BECK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1639 PINE DR
Mailing Address - Street 2:
Mailing Address - City:GROVE
Mailing Address - State:OK
Mailing Address - Zip Code:74344-5503
Mailing Address - Country:US
Mailing Address - Phone:918-786-6944
Mailing Address - Fax:918-787-8661
Practice Address - Street 1:1639 PINE DR
Practice Address - Street 2:
Practice Address - City:GROVE
Practice Address - State:OK
Practice Address - Zip Code:74344-5503
Practice Address - Country:US
Practice Address - Phone:918-786-6944
Practice Address - Fax:918-787-8661
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-10
Last Update Date:2012-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK17224173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine