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Individual

JOHN D BEVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
560 S LOOP RD, EDGEWOOD, KY 41017-3405
(859) 301-2663
(859) 301-0655
Mailing address
560 S LOOP RD, EDGEWOOD, KY 41017-3405
(859) 301-2663
(859) 301-0655

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
20624
KY
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
20624
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000249592
ANTHEM
KY
01
0428850004
MEDICARE DME
KY
01
200045150
RAILROAD MEDICARE
KY
05
64206246
KY
01
90008962
MEDICAID DME
KY
01
CB8861
RAILROAD MEDICARE
KY
Enumeration date
06/01/2005
Last updated
01/21/2014
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