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NPI 1780689117

NPI 1780689117 : JAMES W BEAN MD : CENTERVILLE, OH

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General NPI Number Information
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    NPI Number           |    1780689117
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    Entity Type          |    Individual 
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    Provider Name        |    JAMES W BEAN MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/14/2005
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    Last Update Date     |    10/05/2012
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Provider Practice Location Address
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    Address Line         |    6720 LOOP RD 
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    City                 |    CENTERVILLE
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    State                |    OH
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    Zip                  |    45459-2161
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    Country              |    US
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    Telephone            |    937-433-4922
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    Fax                  |    937-433-6520
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Provider Business Mailing Address
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    Address Line         |    6720 LOOP RD 
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    City                 |    CENTERVILLE
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    State                |    OH
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    Zip                  |    45459-2161
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    Country              |    US
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    Telephone            |    937-433-4922
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    Fax                  |    937-433-6520
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207YX0007X
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    Taxonomy Name        |    Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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    License Number       |    35037257B
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    License Number State |    OH
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