Provider Demographics
NPI:1366212029
Name:BECKHAM, TAYLOR ANNE (MSPAS, PA-C)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ANNE
Last Name:BECKHAM
Suffix:
Gender:F
Credentials:MSPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 HUGHES RD STE 1100
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-2236
Mailing Address - Country:US
Mailing Address - Phone:256-325-8971
Mailing Address - Fax:
Practice Address - Street 1:44 HUGHES RD STE 1100
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-2236
Practice Address - Country:US
Practice Address - Phone:256-325-8971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1924207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology