Provider Demographics
NPI:1427289958
Name:HENRY J BECKWITT MD PC
Entity type:Organization
Organization Name:HENRY J BECKWITT MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BECKWITT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-573-7900
Mailing Address - Street 1:4770 E PRINCETON AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-5016
Mailing Address - Country:US
Mailing Address - Phone:303-573-7900
Mailing Address - Fax:
Practice Address - Street 1:4101 W CONEJOS PL STE 300
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-1349
Practice Address - Country:US
Practice Address - Phone:303-573-7900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15307207RC0000X, 207RG0300X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01153071Medicaid
CO1528191053OtherNPI(INDIVIDUAL)
CO1528191053OtherNPI(INDIVIDUAL)
COD22833Medicare UPIN