Provider Demographics
NPI:1528197316
Name:BEAMAN, RHETT K (DC)
Entity Type:Individual
Prefix:DR
First Name:RHETT
Middle Name:K
Last Name:BEAMAN
Suffix:
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:PO BOX 34207
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-4207
Mailing Address - Country:US
Mailing Address - Phone:702-474-4400
Mailing Address - Fax:702-474-1307
Practice Address - Street 1:8960 W CHEYENNE AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-8929
Practice Address - Country:US
Practice Address - Phone:702-474-4400
Practice Address - Fax:702-474-1307
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB-874111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVU86640Medicare UPIN
NV86640Medicare UPIN
NV35336Medicare PIN