MEDICARE: DR. ALBERT L BEAN JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	30591	TN

General Provider Information

NPI Number	:	1538160601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALBERT L BEAN JR. MD

Provider Business Mailing Address
First Line	:	950 HARBOR VIEW DR
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38103-8838
Country	:	US
Telephone Number	:	901-870-1669
Fax Number	:	901-881-5673

Provider Business Practice Location Address
First Line	:	950 HARBOR VIEW DR
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38103-8838
Country	:	US
Telephone Number	:	901-870-1669
Fax Number	:	901-881-5673

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	07/08/2007

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