Provider Demographics
NPI:1619957552
Name:BEAUMONT, GILLES XAVIER (DC)
Entity Type:Individual
Prefix:DR
First Name:GILLES
Middle Name:XAVIER
Last Name:BEAUMONT
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 1:801 DOWNTOWNER BLVD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-5403
Mailing Address - Country:US
Mailing Address - Phone:251-341-1211
Mailing Address - Fax:251-414-5104
Practice Address - Street 1:801 DOWNTOWNER BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-5403
Practice Address - Country:US
Practice Address - Phone:251-341-1211
Practice Address - Fax:251-414-5104
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1080111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51025978OtherBCBS OF AALABAMA
AL44-10081OtherUNITED HEALTH CARE
AL000025978Medicare PIN
AL44-10081OtherUNITED HEALTH CARE