Provider Demographics
NPI:1588987192
Name:BECKHAM, RENE JOAN (MD)
Entity type:Individual
Prefix:DR
First Name:RENE
Middle Name:JOAN
Last Name:BECKHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6069 N 56TH ST
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-5101
Mailing Address - Country:US
Mailing Address - Phone:480-323-9489
Mailing Address - Fax:480-368-9861
Practice Address - Street 1:275 E GERMANN RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-2905
Practice Address - Country:US
Practice Address - Phone:480-323-9489
Practice Address - Fax:480-368-9861
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-10
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ19126207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZE66700Medicare UPIN