Provider Demographics
NPI:1548223779
Name:BECK, TIMOTHY SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:SCOTT
Last Name:BECK
Suffix:
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 1:58 BIG A RD
Mailing Address - Street 2:
Mailing Address - City:TOCCOA
Mailing Address - State:GA
Mailing Address - Zip Code:30577-6017
Mailing Address - Country:US
Mailing Address - Phone:706-886-6435
Mailing Address - Fax:706-827-5096
Practice Address - Street 1:30 COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:GA
Practice Address - Zip Code:30525-4295
Practice Address - Country:US
Practice Address - Phone:706-782-5044
Practice Address - Fax:706-827-5093
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA054546207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA720172314BMedicaid
GA867920OtherBCBS PROVIDER NUMBER
GA720172314AMedicaid
GA720172314BMedicaid
GAH70415Medicare UPIN