Provider Demographics
NPI:1710109673
Name:BECKHAM, JAMES EUGENE III (JEB BECKHAM MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EUGENE
Last Name:BECKHAM
Suffix:III
Gender:M
Credentials:JEB BECKHAM MD
Other - Prefix:
Other - First Name:JEB
Other - Middle Name:EUGENE
Other - Last Name:BECKHAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:JEB BECKHAM MD
Mailing Address - Street 1:3210 RESERVE DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30319-3030
Mailing Address - Country:US
Mailing Address - Phone:404-271-9397
Mailing Address - Fax:
Practice Address - Street 1:3210 RESERVE DR
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30319-3030
Practice Address - Country:US
Practice Address - Phone:404-271-9397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA058440207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology