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Individual
JOSEPH K BETHLE
Active
Individual
JOSEPH K BETHLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
630
SC
363AS0400X
Surgical Physician Assistant
A630
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
QM0497
—
SC
Enumeration date
04/22/2006
Last updated
02/01/2022
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