Provider Demographics
NPI:1760522072
Name:EARL C. BEEKS, JR., INC.
Entity Type:Organization
Organization Name:EARL C. BEEKS, JR., INC.
Other - Org Name:EARL C. BEEKS, JR., M. D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EARL
Authorized Official - Middle Name:C
Authorized Official - Last Name:BEEKS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:314-567-3232
Mailing Address - Street 1:8420 DELMAR BLVD
Mailing Address - Street 2:SUITE 402
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63124-2170
Mailing Address - Country:US
Mailing Address - Phone:314-567-3232
Mailing Address - Fax:314-567-5380
Practice Address - Street 1:8420 DELMAR BLVD
Practice Address - Street 2:SUITE 402
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63124-2170
Practice Address - Country:US
Practice Address - Phone:314-567-3232
Practice Address - Fax:314-567-5380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO36260261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
E38706Medicare UPIN