Individual
DR. CARLA JOLENE BECKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD/PHD
Contact information
Practice address
711 TROY SCHENECTADY RD STE 119, LATHAM, NY 12110-2454
(518) 786-9131
(518) 786-9136
Mailing address
711 TROY SCHENECTADY RD STE 203, LATHAM, NY 12110-2461
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
267759
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04203605
—
NY
Enumeration date
05/22/2009
Last updated
01/08/2020
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