Provider Demographics
NPI:1134270895
Name:BEANE, PAUL JOSEPH (DC)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:JOSEPH
Last Name:BEANE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 LINCOLN ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:SITKA
Mailing Address - State:AK
Mailing Address - Zip Code:99835-7546
Mailing Address - Country:US
Mailing Address - Phone:907-747-2726
Mailing Address - Fax:907-747-6126
Practice Address - Street 1:315 LINCOLN ST
Practice Address - Street 2:SUITE 207
Practice Address - City:SITKA
Practice Address - State:AK
Practice Address - Zip Code:99835-7546
Practice Address - Country:US
Practice Address - Phone:907-747-2726
Practice Address - Fax:907-747-6126
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK422111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK160604Medicare ID - Type Unspecified