Provider Demographics
NPI:1942267364
Name:BEEBE, GEORGE JAMES (PA)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:JAMES
Last Name:BEEBE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:MR
Other - First Name:JIM
Other - Middle Name:
Other - Last Name:BEEBE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:9300 E 29TH ST N
Mailing Address - Street 2:SUITE 310
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-2182
Mailing Address - Country:US
Mailing Address - Phone:316-858-9000
Mailing Address - Fax:316-858-9005
Practice Address - Street 1:9300 E 29TH ST N
Practice Address - Street 2:SUITE 310
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2182
Practice Address - Country:US
Practice Address - Phone:316-858-9000
Practice Address - Fax:316-858-9005
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1500757363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P27408Medicare UPIN
KS426816Medicare ID - Type Unspecified