Individual
MICHAEL T BECKUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
840 N OAK AVE, RULEVILLE, MS 38771-3227
(662) 756-2711
(662) 756-4114
Mailing address
127 S. GLENBROOK, GRENADA, MS 38901
(662) 229-5367
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R798671
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00123578
—
MS
Enumeration date
05/09/2007
Last updated
01/29/2015
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