Basic Information
| Provider Information | |||||||||
| NPI: | 1245641273 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BECK | ||||||||
| FirstName: | AUSTIN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2200 JEFFERSON AVE | ||||||||
| Address2: | 5TH FLOOR MERCY PHO/CVO | ||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436047101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192519830 | ||||||||
| FaxNumber: | 4192511826 | ||||||||
| Practice Location | |||||||||
| Address1: | 83 WELLNESS WAY LANE | ||||||||
| Address2: | 1ST FLOOR | ||||||||
| City: | BENTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420257156 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2705278601 | ||||||||
| FaxNumber: | 2705279815 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2014 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 49251 | KY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.