Individual
TODD HARRISON BECKSTEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
419 S WASHINGTON ST, SUITE 102, CASPER, WY 82601-2951
(307) 577-4220
(307) 235-0931
Mailing address
419 S WASHINGTON ST, SUITE 102, CASPER, WY 82601-2951
(307) 577-4220
(307) 235-0931
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
6214A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0069870
—
MT
05
—
01155342
—
CO
01
—
020043010
RAILROAD MEDICARE
WY
05
—
0575142
—
IA
05
—
114484700
—
WY
01
—
308059
BLUE CROSS BLUE SHIELD
WY
05
—
520883072
—
NE
05
—
8359366
—
WA
01
—
W308059
WYOMING MEDICARE
WY
Enumeration date
09/21/2005
Last updated
06/24/2010
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