Provider Demographics
NPI:1487635843
Name:BEALE, GEORGE LEMUEL (MD FACC)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:LEMUEL
Last Name:BEALE
Suffix:
Gender:M
Credentials:MD FACC
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 398
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:AL
Mailing Address - Zip Code:36251-0398
Mailing Address - Country:US
Mailing Address - Phone:256-354-2101
Mailing Address - Fax:256-354-2109
Practice Address - Street 1:83430 HWY 9
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:AL
Practice Address - Zip Code:36251
Practice Address - Country:US
Practice Address - Phone:256-354-2101
Practice Address - Fax:256-354-2109
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12035207R00000X, 208D00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000014915Medicaid
AL000014915Medicare Oscar/Certification
AL000014915Medicaid