Individual
CONSTANCE BECKOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
203 E 4TH AVE, RANSON, WV 25438-1617
(304) 725-6343
(304) 725-5523
Mailing address
203 E 4TH AVE, RANSON, WV 25438-1617
(304) 725-6343
(304) 725-5523
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
14590
NV
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
26847
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477540938
—
WV
Enumeration date
09/30/2005
Last updated
01/08/2021
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