Provider Demographics
NPI:1689673899
Name:BEINEKE, DANIEL D (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:D
Last Name:BEINEKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1700 EASTPOINT PKWY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4140
Mailing Address - Country:US
Mailing Address - Phone:502-753-4949
Mailing Address - Fax:502-753-4950
Practice Address - Street 1:1210 KY HIGHWAY 36 E
Practice Address - Street 2:
Practice Address - City:CYNTHIANA
Practice Address - State:KY
Practice Address - Zip Code:41031-7498
Practice Address - Country:US
Practice Address - Phone:859-234-2300
Practice Address - Fax:859-235-3699
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY192172085R0202X, 208D00000X
OH35.030273208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64192172Medicaid
KY8759011OtherUNITED HEALTHCARE UPIN
KY000000058821OtherANTHEM B/C UPIN
KYC74139OtherBLUEGRASS FAMILY HEALTH
KYC74139Medicare UPIN
KY0511601Medicare UPIN