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Individual

DR. JACOB JOSEPH BECKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1 HOSPITAL DR # DC018.00, COLUMBIA, MO 65201-5276
(573) 884-5697
(573) 884-8876
Mailing address
1 HOSPITAL DR # DC018.00, COLUMBIA, MO 65201-5276
(573) 884-5697
(573) 884-8876

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
2011019836
MO
2085R0202X
Diagnostic Radiology Physician
DR.0056443
CO
2085R0202X
Diagnostic Radiology Physician
Primary
MD2016-0110
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2011019836
MISSOURI STATE LICENSE
MO
Enumeration date
08/12/2011
Last updated
06/24/2016
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