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
1	363A00000X	Physician Assistant	146	TN
2	363AM0700X	Medical Physician Assistant	146	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	970015511	OTHER	TN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	TN0114	OTHER	TN	JOHN DEERE HEALTHCARE
2	TN0144	OTHER	TN	JOHN DEERE HEALTHCARE
3	3094425	OTHER	TN	BLUE CROSS BLUE SHIELD
5	TN0106	OTHER	TN	JOHN 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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Directions to “ STEPHEN BEAN P.A.” Practice Location

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