Healthcare Provider Details

I. General information

NPI: 1821007303
Provider Name (Legal Business Name): RODNEY DALE BEELER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 04/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 MEDICAL ARTS DR
HUNTINGBURG IN
47542-9521
US

IV. Provider business mailing address

2142 KETTLES HILL CT
EVANSVILLE IN
47725-8266
US

V. Phone/Fax

Practice location:
  • Phone: 812-683-6438
  • Fax: 812-683-6103
Mailing address:
  • Phone: 812-868-1209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number01052914A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: