Provider Demographics
NPI:1801975628
Name:BEAMS, AUSIE JEFFREY (PT)
Entity type:Individual
Prefix:
First Name:AUSIE
Middle Name:JEFFREY
Last Name:BEAMS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 REVERE RD
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405-8761
Mailing Address - Country:US
Mailing Address - Phone:404-944-3991
Mailing Address - Fax:
Practice Address - Street 1:6551 HIGHWAY 69 S
Practice Address - Street 2:SUITE B
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-6578
Practice Address - Country:US
Practice Address - Phone:205-758-5832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA007541225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGA007541OtherSTATE LISC NUMBER