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General NPI Number Information
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NPI Number | 1801284633
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Entity Type | Individual
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Provider Name | ANGELA BEVILL D.O.
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Gender | Female
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Dates
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Enumeration Date | 01/01/2015
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 905C S FRONTAGE RD
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City | MERIDIAN
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State | MS
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Zip | 39301-6113
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Country | US
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Telephone | 601-482-4955
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Fax |
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Provider Business Mailing Address
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Address Line | 5824 SYLVESTER ST
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-4073
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Country | US
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Telephone | 228-327-3281
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 338511
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO2105
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 24326
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License Number State | MS
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