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NPI Code Detail

MEDICARE: KENNETH E BEAN

MEDICARE: KENNETH E BEAN
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
11223G0001XGeneral Practice Dentistry5513KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21055673OTHERKSDORAL

General Provider Information

NPI Number : 1609842046
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNETH E BEAN
Provider Business Mailing Address
First Line : 113 S MAIN ST
Second Line :
City : ULYSSES
State : KS
Zip : 67880-2519
Country : US
Telephone Number : 620-424-4499
Fax Number :
Provider Business Practice Location Address
First Line : 113 S MAIN ST
Second Line :
City : ULYSSES
State : KS
Zip : 67880-2519
Country : US
Telephone Number : 620-424-4499
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2006
Last Update Date : 03/13/2009

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Directions to “ KENNETH E BEAN ” Practice Location

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