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NPI Code Detail

MEDICARE: STEPHEN BEAN P.A.

MEDICARE: STEPHEN BEAN P.A.
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
1363A00000XPhysician Assistant146TN
2363AM0700XMedical Physician Assistant146TN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4970015511OTHERTNRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1TN0114OTHERTNJOHN DEERE HEALTHCARE
2TN0144OTHERTNJOHN DEERE HEALTHCARE
33094425OTHERTNBLUE CROSS BLUE SHIELD
5TN0106OTHERTNJOHN DEERE HEALTHCARE

General Provider Information

NPI Number : 1780636340
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN BEAN P.A.
Provider Business Mailing Address
First Line : 1422 OLD WEISGARBER RD
Second Line :
City : KNOXVILLE
State : TN
Zip : 37909-1293
Country : US
Telephone Number : 865-558-4400
Fax Number :
Provider Business Practice Location Address
First Line : 1422 OLD WEISGARBER RD
Second Line :
City : KNOXVILLE
State : TN
Zip : 37909-2674
Country : US
Telephone Number : 865-558-4400
Fax Number : 865-558-4471
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2006
Last Update Date : 10/29/2018

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1457382780 — DR. THEODORE W JONES PHD
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Directions to “ STEPHEN BEAN P.A.” Practice Location

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