Provider Demographics
NPI:1326036609
Name:BECK, BEN L (CRNA)
Entity type:Individual
Prefix:MR
First Name:BEN
Middle Name:L
Last Name:BECK
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 BAYSHORE DR
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-9244
Mailing Address - Country:US
Mailing Address - Phone:501-282-3824
Mailing Address - Fax:501-262-5000
Practice Address - Street 1:420 BAYSHORE DR
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-9244
Practice Address - Country:US
Practice Address - Phone:501-282-3824
Practice Address - Fax:501-262-5000
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC00905367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR125726701OtherARKANSAS MEDICAID
AR5F648C910OtherARKANSAS MEDICARE
AR5F648OtherARKANSAS BLUE CROSS BLUE SHIELD
P00291405OtherRR MEDICARE GROUP CK6327