Provider Demographics
NPI:1194817056
Name:BESEMAN, RODNEY ARTHUR II (DC)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:ARTHUR
Last Name:BESEMAN
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 SUBURBAN AVE S
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55106-6632
Mailing Address - Country:US
Mailing Address - Phone:651-776-3345
Mailing Address - Fax:651-778-2347
Practice Address - Street 1:1712 SUBURBAN AVE S
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55106-6632
Practice Address - Country:US
Practice Address - Phone:651-776-3345
Practice Address - Fax:651-778-2347
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3030111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00075527OtherPALMETTO GBA MC
3C030BEOtherBCBS