Provider Demographics
NPI:1851390355
Name:BECKMAN, ALAN C (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:C
Last Name:BECKMAN
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:PO BOX 910082
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40591-0082
Mailing Address - Country:US
Mailing Address - Phone:877-839-9517
Mailing Address - Fax:903-531-2337
Practice Address - Street 1:1740 NICHOLASVILLE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1431
Practice Address - Country:US
Practice Address - Phone:502-226-3858
Practice Address - Fax:502-227-5081
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY266592085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000051531OtherANTHEM B/C PIN
KYF23735OtherBLUEGRASS FAMILY HEALTH
KY64266596Medicaid
KY64266596Medicaid
KY0599901Medicare PIN