Provider Demographics
NPI:1871692285
Name:BECKETT, DONALD EDWARD (DPM)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:EDWARD
Last Name:BECKETT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10144 DEERCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2936
Mailing Address - Country:US
Mailing Address - Phone:813-210-3301
Mailing Address - Fax:806-993-4786
Practice Address - Street 1:10144 DEERCLIFF DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2936
Practice Address - Country:US
Practice Address - Phone:813-210-3301
Practice Address - Fax:806-993-4786
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO1530213E00000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Not Answered213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
T55566Medicare UPIN
FL87832Medicare ID - Type Unspecified