Becker, Jerry
Becker, Jerry is an individual health care provider with primary practice located at 415 W Columbia St , Evansville IN 47710-1656. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Becker, Jerry can be contacted via phone (812) 464-9133.Contact Information
Primary practice address
415 W Columbia St
Evansville IN 47710-1656
Phone: (812) 464-9133
Fax: (812) 464-0559
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 01019382A | Indiana |
Profile Details
| NPI number | 1023091725 |
|---|---|
| LBN Legal business name | Becker, Jerry |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 28th, 2005 |
| Last updated | Feb 23rd, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023091725 | NPPES |
| Indiana | MEDICAID | 100344130 | |
| Indiana | MEDICAID | 64003940 |
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