Individual
JACOB MARTIN BEANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
712 OAKLAWN AVE, CRANSTON, RI 02920-2858
(401) 944-0044
Mailing address
455 TOLL GATE ROAD, PRC AND CREDENTIALING, WARWICK, RI 02886-2759
(401) 273-0641
(401) 273-2919
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
PA01574
RI
363A00000X
Physician Assistant
Primary
PA01574
RI
Other
Enumeration date
04/28/2023
Last updated
04/20/2026
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