Provider Demographics
NPI:1386083186
Name:BECK, JARED DANIEL (DO)
Entity type:Individual
Prefix:DR
First Name:JARED
Middle Name:DANIEL
Last Name:BECK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1771 COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:MO
Mailing Address - Zip Code:65355-3096
Mailing Address - Country:US
Mailing Address - Phone:660-438-5193
Mailing Address - Fax:
Practice Address - Street 1:1771 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:MO
Practice Address - Zip Code:65355-3096
Practice Address - Country:US
Practice Address - Phone:660-438-5193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6971207Q00000X
MO2016024167207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine