Provider Demographics
NPI:1467557678
Name:BEAN CENTER FOR FOOT SURGERY INC
Entity Type:Organization
Organization Name:BEAN CENTER FOR FOOT SURGERY INC
Other - Org Name:SIERRA CENTER FOR FOOT SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:KIMBALL
Authorized Official - Last Name:BEAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:775-882-1441
Mailing Address - Street 1:1801 N CARSON ST
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-1216
Mailing Address - Country:US
Mailing Address - Phone:775-882-1441
Mailing Address - Fax:775-882-6844
Practice Address - Street 1:1801 N CARSON ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-1216
Practice Address - Country:US
Practice Address - Phone:775-882-1441
Practice Address - Fax:775-882-6844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV486ASC 10261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV9C0001020OtherMEDICARE ID-UNSPECIFIED