Basic Information
| Provider Information | |||||||||
| NPI: | 1417166299 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BECKMANN | ||||||||
| FirstName: | BRAD | ||||||||
| MiddleName: | BRUCE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 344 FERNANDEZ LN | ||||||||
| Address2: | |||||||||
| City: | CAMERON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283266080 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8305709387 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2817 REILLY ROAD | ||||||||
| Address2: | |||||||||
| City: | FT. BRAGG | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9109077000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2007 | ||||||||
| LastUpdateDate: | 06/27/2013 | ||||||||
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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 | 207P00000X | 2011-01921 | NC | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.