Provider Demographics
NPI:1205804473
Name:BECKER, PAUL L (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:L
Last Name:BECKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 FORT SANDERS WEST BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3355
Mailing Address - Country:US
Mailing Address - Phone:865-769-4500
Mailing Address - Fax:865-769-4557
Practice Address - Street 1:260 FORT SANDERS WEST BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3355
Practice Address - Country:US
Practice Address - Phone:865-558-4400
Practice Address - Fax:865-769-4557
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD31304207X00000X
TN31304207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN200037583OtherRAILROAD MEDICARE
TN3847085Medicaid
TN7904152OtherAETNA
TN3134233OtherBLUE CROSS BLUE SHIELD
KY7100119450OtherKY MEDICAID
P00851100OtherRAILROAD MEDICARE
TNTN0172OtherJOHN DEERE HEALTHCARE
TNTN0196OtherJOHN DEERE HEALTHCARE
TNTN0195OtherJOHN DEERE HEALTHCARE
3847084Medicare ID - Type Unspecified
3847086Medicare ID - Type Unspecified
TN3847085Medicaid
TN3134233OtherBLUE CROSS BLUE SHIELD
KY7100119450OtherKY MEDICAID