Provider Demographics
NPI:1578617536
Name:BEUKELMAN, CARL JAY (DC)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:JAY
Last Name:BEUKELMAN
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 1:162 E 29TH ST
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-2724
Mailing Address - Country:US
Mailing Address - Phone:970-667-7159
Mailing Address - Fax:970-593-1033
Practice Address - Street 1:162 E 29TH ST
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-2724
Practice Address - Country:US
Practice Address - Phone:970-667-7159
Practice Address - Fax:970-593-1033
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05484111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0061408Medicaid
IA29311OtherBLUE CROSS BLUE SHIELD
IA29311Medicare ID - Type Unspecified
IA29311OtherBLUE CROSS BLUE SHIELD