Basic Information
| Provider Information | |||||||||
| NPI: | 1457311854 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BECKMAN III | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1010 N COUNTRY CLUB DR | ||||||||
| Address2: | |||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852013309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4804612409 | ||||||||
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| Practice Location | |||||||||
| Address1: | 801 E WILLIAMS AVE | ||||||||
| Address2: | |||||||||
| City: | FALLON | ||||||||
| State: | NV | ||||||||
| PostalCode: | 894063052 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7754233151 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2006 | ||||||||
| LastUpdateDate: | 10/11/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 01049931A | IN | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | 7512 | NV | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 100503310 | 05 | NV | MEDICAID |