Provider Demographics
NPI:1013948058
Name:BEEKS, DAVID (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:BEEKS
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 1:2702 NAVARRE AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-3223
Mailing Address - Country:US
Mailing Address - Phone:419-696-3131
Mailing Address - Fax:
Practice Address - Street 1:2702 NAVARRE AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3223
Practice Address - Country:US
Practice Address - Phone:419-696-3131
Practice Address - Fax:419-696-7015
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD35201207X00000X
OH35.089259207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2723628Medicaid
OHH062070Medicare PIN
OH4204261Medicare PIN
H39141Medicare UPIN
OHH062070Medicare PIN