MEDICARE: LINDSEY C BEVILLE PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA-462	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	511-30640	OTHER	AL	BLUE CROSS OF AL

General Provider Information

NPI Number	:	1114025731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY C BEVILLE PA

Provider Business Mailing Address
First Line	:	3700 DAUPHIN ST STE A
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36608-1725
Country	:	US
Telephone Number	:	251-340-6600
Fax Number	:	251-479-7164

Provider Business Practice Location Address
First Line	:	3700 DAUPHIN ST STE A
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36608-1725
Country	:	US
Telephone Number	:	251-340-6600
Fax Number	:	251-479-7164

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	03/15/2023

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Directions to “ LINDSEY C BEVILLE PA” Practice Location

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