Provider Demographics
NPI:1114025731
Name:BEVILLE, LINDSEY C (PA)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:C
Last Name:BEVILLE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 DAUPHIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-1725
Mailing Address - Country:US
Mailing Address - Phone:251-340-6600
Mailing Address - Fax:251-479-7164
Practice Address - Street 1:3700 DAUPHIN ST STE A
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1725
Practice Address - Country:US
Practice Address - Phone:251-340-6600
Practice Address - Fax:251-479-7164
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA-462363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL141824Medicaid
AL511-30640OtherBLUE CROSS OF AL
AL141824Medicaid
AR102I976815Medicare PIN