Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 35037257B | OH |
NPI | 1780689117 |
---|---|
Provider Name | Dr. James W Bean |
First Address | Centerville, OH 45459-2161 |
Second Address | Centerville, OH 45459-2161 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2005 |
Last Update Date | 05/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
243409 | (05) | OH |
A74863 | (02) | OH |