Individual
DR. VINCENT GERARD BECKER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1301 SUNSET DR, STE 3, JOHNSON CITY, TN 37604-7906
(423) 926-4966
(423) 926-1823
Mailing address
1301 SUNSET DR, STE 3, JOHNSON CITY, TN 37604-7906
(423) 926-4966
(423) 926-1823
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
34969
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3862458
—
TN
01
—
4007341
BCBS
TN
01
—
64031164
KENTUCKY MEDICAID
KY
01
—
7239875
VIRGINIA MEDICAID
VA
01
—
89064NJ
NORTH CAROLINA MEDICAID
NC
Enumeration date
05/03/2006
Last updated
07/09/2007
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