Provider Demographics
NPI:1205909587
Name:BEVILLE, JANELLE M (MD)
Entity type:Individual
Prefix:DR
First Name:JANELLE
Middle Name:M
Last Name:BEVILLE
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:540 MCCALLIE AVE
Mailing Address - Street 2:SUITE 450
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37402-2089
Mailing Address - Country:US
Mailing Address - Phone:423-634-5887
Mailing Address - Fax:423-634-3139
Practice Address - Street 1:540 MCCALLIE AVE
Practice Address - Street 2:SUITE 450
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402-2089
Practice Address - Country:US
Practice Address - Phone:423-634-5887
Practice Address - Fax:423-634-3139
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNMD121272083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNF53490Medicare UPIN