SAMUEL WELLING BECKSTEAD (NPI# 1487041380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487041380 |
| Entity Type | Individual |
| Full Name | SAMUEL WELLING BECKSTEAD |
| Credential | DO |
| Practice Address |
2100 Providence Way Idaho Falls ID 83404-4951 |
| Practice Telephone | 2085296600 |
| Practice Fax Number | 2085296602 |
| Mailing Telephone | 0825296600 |
| Mailing Fax Number | 2085296602 |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2020-11-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | O-1389 | ID | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | OS020090 | PA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care | ||
| Y | 207WX0200X |
Ophthalmology Specialization: Ophthalmic Plastic and Reconstructive Surgery |
O-1389 | ID | Allopathic & Osteopathic Physicians |
| Street Address |
2100 PROVIDENCE WAY |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83404-4951 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063563823 | Matthew P Traynor | Ophthalmology | 2100 Providence Way, Idaho Falls, ID 83404 | 2007-01-16 |
| 1932544111 | Jason Gerald Hooton | Ophthalmology | 2100 Providence Way, Idaho Falls, ID 83404 | 2013-05-01 |
| 1790052603 | Premier Eye Care of Eastern Idaho Pllc | Ophthalmology | 2100 Providence Way, Idaho Falls, ID 83404 | 2011-11-20 |
| 1710111224 | Kyle G Thompson | Ophthalmology | 2100 Providence Way, Idaho Falls, ID 83404-6236 | 2009-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750809 | Joshua M Murphy | Dentist | 1580 Elk Creek Dr., Idaho Falls, ID 83404 | 2020-11-03 |
| 1427618958 | Eastern Idaho Endodontics | Dentist | 3335 S. Holmes Ave, Idaho Falls, ID 83404 | 2019-06-17 |
| 1942863600 | Muhammad Arslan Khan | Student in an Organized Health Care Education/Training Program | 2860 Channing Way Suite 214, Idaho Falls, ID 83404 | 2019-04-18 |
| 1942771043 | Physician's Choice Cardiology, Pllc | Internal Medicine | 3302 Valencia, Suite 201, Idaho Falls, ID 83404 | 2018-12-16 |
| 1609358761 | Cardiac Cath Lab of Idaho Falls | Internal Medicine | 3311 Valencia Drive, Idaho Falls, ID 83404 | 2018-09-05 |
| 1083196380 | Hannah Golden | Occupational Therapist | 1460 Elk Creek, Idaho Falls, ID 83404 | 2018-09-04 |
| 1316423049 | Lindsay Sessions | Speech-Language Pathologist | 2210 Niagara St, Idaho Falls, ID 83404 | 2018-07-16 |
| 1720574023 | Bmh, Inc. | Anesthesiology | 3302 Valencia Dr., Suite 201, Idaho Falls, ID 83404 | 2018-07-10 |
| 1093237935 | Jason Earl Bailey | Contractor | 3100 S Woodruff Ave., Idaho Falls, ID 83404 | 2017-07-12 |
| 1235682121 | Mountain Falls Quick Care | Clinic/Center | 1995 E 17th St #1, Idaho Falls, ID 83404 | 2016-07-27 |
| Find all providers in zip 83404 | ||||
| Taxonomy Code | 207WX0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| Specialization | Ophthalmic Plastic and Reconstructive Surgery |
| A physician who specializes in oculofacial plastic and reconstructive surgery. This subspecialty combines orbital and periocular surgery with facial plastic surgery, and includes aesthetic and reconstructive surgery of the face, orbit, eyelid, and lacrimal system. Practitioners evaluate, diagnose and treat conditions involving the eyelids, brows, midface, orbits, lacrimal systems and surrounding and supporting structures of the face and neck. |
| Notes: Source: American Academy of Ophthalmology, 2015. www.aao.org [1/1/2016: new] |
| City | IDAHO FALLS |
| Zip Code | 83404 |
Please comment or provide details below to improve the information on SAMUEL WELLING BECKSTEAD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.