Provider Demographics
NPI:1912936071
Name:PATE, CAROLINE BEESLEY (OD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:BEESLEY
Last Name:PATE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:CAROLINE
Other - Middle Name:ANN
Other - Last Name:BEESLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1716 UNIVERSITY BOULEVARD
Mailing Address - Street 2:HPB G080A
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35294-0001
Mailing Address - Country:US
Mailing Address - Phone:205-975-2020
Mailing Address - Fax:205-934-6755
Practice Address - Street 1:1716 UNIVERSITY BOULEVARD
Practice Address - Street 2:HPB G080A
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-0001
Practice Address - Country:US
Practice Address - Phone:205-975-2020
Practice Address - Fax:205-934-6755
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALSB25152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL9961765Medicaid
AL051523178OtherBCBS
ALV00749OtherVIVA
AL9961765Medicaid
AL051523178Medicare PIN