Beckwith, Lee Granger

Beckwith, Lee Granger is an individual health care provider with primary practice located at Ssmhealth Good Samaritan Hospital , Mount Vernon IL 62864-6286. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Beckwith, Lee Granger can be contacted via phone (573) 450-9134.

Contact Information

Primary practice address
Ssmhealth Good Samaritan Hospital Mount Vernon IL 62864-6286
Phone: (573) 450-9134
Fax: (618) 899-4720
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 101537 Missouri

Profile Details

NPI number 1790761609
LBN Legal business name Beckwith, Lee Granger
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 22nd, 2005
Last updated Jul 12th, 2022 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790761609 NPPES
Missouri MEDICAID 203381017
Missouri MEDICAID 100216240B

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