Provider Demographics
NPI:1568435329
Name:BELUE, JOE B (MD)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:B
Last Name:BELUE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5500
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75712-5500
Mailing Address - Country:US
Mailing Address - Phone:903-324-6400
Mailing Address - Fax:903-593-7852
Practice Address - Street 1:534 S BECKHAM AVE
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702-8310
Practice Address - Country:US
Practice Address - Phone:903-531-4530
Practice Address - Fax:903-531-4553
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD2088207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX123000OtherCHIPS
TX752616977026OtherTRICARE CHAMPUS
TX4355815OtherAETNA
TXBE083Y680OtherBCBS
TX123000OtherCHIPS
TX4355815OtherAETNA