Individual
DR. JERRY BECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
415 W COLUMBIA ST, EVANSVILLE, IN 47710-1656
(812) 464-9133
(812) 464-0559
Mailing address
415 W COLUMBIA ST, EVANSVILLE, IN 47710-1656
(812) 464-9133
(812) 464-0559
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01019382A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100344130
—
IN
05
—
64003940
—
KY
Enumeration date
11/28/2005
Last updated
02/23/2010
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