Provider Demographics
NPI:1205939444
Name:BEELER, BEN DANIEL (DC)
Entity type:Individual
Prefix:
First Name:BEN
Middle Name:DANIEL
Last Name:BEELER
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 1:6117 S MINGO RD STE C
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-6313
Mailing Address - Country:US
Mailing Address - Phone:918-615-3433
Mailing Address - Fax:918-615-3433
Practice Address - Street 1:6117 S MINGO RD STE C
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-6313
Practice Address - Country:US
Practice Address - Phone:918-615-3433
Practice Address - Fax:918-615-3453
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3685111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK231412005Medicare ID - Type Unspecified
OKU98931Medicare UPIN