Provider Demographics
NPI:1689838070
Name:BECKERMAN, ERIN MIKEL HAY (DO)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MIKEL HAY
Last Name:BECKERMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:MIKEL
Other - Last Name:HAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:108 S FRONTAGE RD W
Mailing Address - Street 2:STE 101
Mailing Address - City:VAIL
Mailing Address - State:CO
Mailing Address - Zip Code:81657-5087
Mailing Address - Country:US
Mailing Address - Phone:970-926-6340
Mailing Address - Fax:970-926-6348
Practice Address - Street 1:400 N PARK AVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:BRECKENRIDGE
Practice Address - State:CO
Practice Address - Zip Code:80424-8850
Practice Address - Country:US
Practice Address - Phone:970-547-9200
Practice Address - Fax:970-262-2196
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO47256207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine