Provider Demographics
NPI:1568469880
Name:BECK, PATRICK B (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:B
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 1:1125 PIERCE ST
Mailing Address - Street 2:STE 100
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51105-1484
Mailing Address - Country:US
Mailing Address - Phone:712-255-8901
Mailing Address - Fax:712-255-9161
Practice Address - Street 1:1125 PIERCE ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51105-1485
Practice Address - Country:US
Practice Address - Phone:712-255-8901
Practice Address - Fax:712-255-9161
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA27125208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2057950Medicaid
IA2057950Medicaid
IAI1582Medicare ID - Type Unspecified