Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SAMUEL WELLING BECKSTEAD, DO
Active Sole ProprietorSAMUEL WELLING BECKSTEAD, DO is a 207WX0200X healthcare provider located in IDAHO FALLS, Idaho. NPI 1487041380 is currently active in the NPPES registry. Verify at CMS.
207WX0200X · IDAHO FALLS, ID
Registration Details
- NPI Number
- 1487041380
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 20, 2015 (11.293375326503 yrs)
- Last Updated
- Nov 5, 2020
- Licenses
-
OS020090 (PA)O-1389 (ID)O-1389 (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2100 PROVIDENCE WAYIDAHO FALLS, ID, 834044951Browse ID providers · Browse ZIP 83404
- Phone
- 2085296600
- Fax
- 2085296602
- Primary Specialty
-
207WX0200X
207WX0200X
- Additional Specialty
- Ophthalmology
- Additional Specialty
- Student (Health Education/Training)
- Additional Specialty
- 207WX0200X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.