Organization
RICKY BECKER MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE CARLSON (OFFICE MANAGER)
(701) 530-3011
Entity
Organization
Contact information
Practice address
1500 INTERCHANGE AVE, STE 100, BISMARCK, ND 58501-2079
(701) 530-3011
Mailing address
1500 INTERCHANGE AVE, STE 100, BISMARCK, ND 58501-2079
(701) 530-3011
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N711225
GROUP
ND
Enumeration date
02/28/2008
Last updated
02/28/2008
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