Provider Demographics
NPI:1972629749
Name:BEAN, ALICIA MARIE (MD)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:MARIE
Last Name:BEAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:222 S KANSAS ST
Mailing Address - Street 2:
Mailing Address - City:RUSSELL
Mailing Address - State:KS
Mailing Address - Zip Code:67665-3000
Mailing Address - Country:US
Mailing Address - Phone:785-483-3333
Mailing Address - Fax:785-483-0781
Practice Address - Street 1:222 S KANSAS ST
Practice Address - Street 2:
Practice Address - City:RUSSELL
Practice Address - State:KS
Practice Address - Zip Code:67665-3000
Practice Address - Country:US
Practice Address - Phone:785-483-3333
Practice Address - Fax:785-483-0781
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-34611207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine