Provider Demographics
NPI:1821007303
Name:BEELER, RODNEY DALE (MD)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:DALE
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 1:2142 KETTLES HILL CT
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47725-8266
Mailing Address - Country:US
Mailing Address - Phone:812-868-1209
Mailing Address - Fax:
Practice Address - Street 1:1900 MEDICAL ARTS DR
Practice Address - Street 2:
Practice Address - City:HUNTINGBURG
Practice Address - State:IN
Practice Address - Zip Code:47542-9521
Practice Address - Country:US
Practice Address - Phone:812-683-6438
Practice Address - Fax:812-683-6103
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01052914A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200235570Medicaid
IN000000594459OtherBLUE SHIELD
INH27133Medicare ID - Type Unspecified
IN131180MMMMedicare PIN