Provider Demographics
NPI:1104991496
Name:BEECROFT, PATTY LEE (MD)
Entity type:Individual
Prefix:DR
First Name:PATTY
Middle Name:LEE
Last Name:BEECROFT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:HAROLD
Other - Middle Name:JAMES
Other - Last Name:BEECROFT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2930 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:CO
Mailing Address - Zip Code:80620-1011
Mailing Address - Country:US
Mailing Address - Phone:970-350-4606
Mailing Address - Fax:970-350-4645
Practice Address - Street 1:1010 A ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-2021
Practice Address - Country:US
Practice Address - Phone:970-313-0400
Practice Address - Fax:970-313-0404
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO27060174400000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO53476808Medicaid
CO53476808Medicaid
CO53476808Medicaid