Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 1080 | AL |
NPI | 1619957552 |
---|---|
Provider Name | Dr. Gilles Xavier Beaumont |
First Address | Mobile, AL 36609-5403 |
Second Address | Mobile, AL 36609-5403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2006 |
Last Update Date | 11/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
44-10081 | UNITED HEALTH CARE (01) | AL |
51025978 | BCBS OF AALABAMA (01) | AL |
T68328 | (02) | AL |