Provider Demographics
NPI:1760727275
Name:BECK, JONATHAN
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:BECK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 910544
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40591-0544
Mailing Address - Country:US
Mailing Address - Phone:859-410-8550
Mailing Address - Fax:859-223-0642
Practice Address - Street 1:771 CORPORATE DR
Practice Address - Street 2:SUITE 610
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-5405
Practice Address - Country:US
Practice Address - Phone:859-410-8550
Practice Address - Fax:859-223-0642
Is Sole Proprietor?:No
Enumeration Date:2012-12-10
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other