Provider Demographics
NPI:1881682177
Name:BEAN, JOSEPH M (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:M
Last Name:BEAN
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 1:1705 E BROADWAY STE 100
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-7167
Mailing Address - Country:US
Mailing Address - Phone:573-874-7800
Mailing Address - Fax:573-443-3627
Practice Address - Street 1:5985 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:HANNIBAL
Practice Address - State:MO
Practice Address - Zip Code:63401-6886
Practice Address - Country:US
Practice Address - Phone:573-406-5800
Practice Address - Fax:573-406-5826
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO1035912085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209988203Medicaid
5132415OtherAETNA
24 01298OtherUNITEDHEALTHCARE
388501OtherHEALTHLINK
25496017OtherBCBS OF KC
G65259OtherMERCY HEALTH PLANS
65201A004OtherTRICARE
117825OtherBCBS OF MO
G65259OtherMERCY HEALTH PLANS
MO011012700Medicare PIN
MO209988203Medicaid
KSH388206Medicare PIN
25496017OtherBCBS OF KC
MO253010635Medicare PIN
MO966335236Medicare PIN
5132415OtherAETNA
24 01298OtherUNITEDHEALTHCARE
MO152360075Medicare PIN
MO127530002Medicare PIN