Provider Demographics
NPI:1184683393
Name:BEELER, JAMES C (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:C
Last Name:BEELER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HARVEST RD
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51104-1034
Mailing Address - Country:US
Mailing Address - Phone:712-239-0521
Mailing Address - Fax:
Practice Address - Street 1:5 HARVEST RD
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104-1034
Practice Address - Country:US
Practice Address - Phone:712-239-0521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA266712085N0700X
SD48582085N0700X
NE231862085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN5141494-00Medicaid
SD7786930Medicaid
IA3051029Medicaid
IA3051029Medicaid
A03939Medicare UPIN
IA32958Medicare ID - Type Unspecified