Provider Demographics
NPI:1740238112
Name:BECK, ERIC R (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:R
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 1:2011 GALLATIN ST SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4510
Mailing Address - Country:US
Mailing Address - Phone:256-382-1603
Mailing Address - Fax:256-382-1607
Practice Address - Street 1:2011 GALLATIN ST SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4510
Practice Address - Country:US
Practice Address - Phone:256-382-1603
Practice Address - Fax:256-382-1607
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL18624208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000023502Medicaid
ALF55413OtherBLUE CROSS UPIN
AL000023502Medicare PIN