Individual
DR. BEVILA JOHN-DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1800 COMMUNITY, CLINTON, MO 64735
(888) 403-1071
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(888) 403-1071
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2017031166
MO
2084P0800X
Psychiatry Physician
33996
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36675
MHN
AZ
05
—
974057
—
AZ
Enumeration date
03/14/2007
Last updated
07/10/2019
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