Provider Demographics
NPI:1720084411
Name:BESHEL, JOHN PATRICK (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PATRICK
Last Name:BESHEL
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 365
Mailing Address - Street 2:
Mailing Address - City:ELON
Mailing Address - State:NC
Mailing Address - Zip Code:27244-0365
Mailing Address - Country:US
Mailing Address - Phone:336-586-0101
Mailing Address - Fax:336-586-0109
Practice Address - Street 1:2551 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5203
Practice Address - Country:US
Practice Address - Phone:336-586-0101
Practice Address - Fax:336-586-0109
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-27
Last Update Date:2014-06-24
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-03-22
Provider Licenses
StateLicense IDTaxonomies
NC2769111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890839MMedicaid
NC890839MMedicaid
NC2453958DMedicare PIN