Provider Demographics
NPI:1194872614
Name:VANBEEK, RODNEY J (MD)
Entity type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:J
Last Name:VANBEEK
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 1:725 S JANESVILLE ST
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:WI
Mailing Address - Zip Code:53563-1775
Mailing Address - Country:US
Mailing Address - Phone:608-868-5800
Mailing Address - Fax:
Practice Address - Street 1:725 S JANESVILLE ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:WI
Practice Address - Zip Code:53563-1775
Practice Address - Country:US
Practice Address - Phone:608-868-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI39174207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32354700Medicaid
G60112Medicare UPIN