MEDICARE: DR. DANIEL JASON BEBO 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	207QA0401X	Addiction Medicine (Family Medicine) Physician	DR.0058073	CO
2	2084P0800X	Psychiatry Physician	35.096046	OH

General Provider Information

NPI Number	:	1558583476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL JASON BEBO MD

Provider Business Mailing Address
First Line	:	PO BOX 636256
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-6256
Country	:	US
Telephone Number	:	513-558-5825
Fax Number	:	513-558-8838

Provider Business Practice Location Address
First Line	:	3131 HARVEY AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45229-3000
Country	:	US
Telephone Number	:	513-585-8227
Fax Number	:	513-585-8278

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	03/15/2023

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