Individual
PAUL RICHARD BECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
175 COUNTRY CLUB DR, BUILDING 100, SUITE E, STOCKBRIDGE, GA 30281-9054
(770) 507-5000
(770) 507-5075
Mailing address
175 COUNTRY CLUB DR, BUILDING 100, SUITE E, STOCKBRIDGE, GA 30281-9054
(770) 507-5000
(770) 507-5075
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
036-114125
IL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
66755
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01915167
BLUE CROSS/BLUE SHIELD
IL
01
—
035958001
DMERC
IL
05
—
036114125
—
IL
01
—
109303
HEALTH ALLIANCE
IL
Enumeration date
08/20/2006
Last updated
11/06/2013
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