Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | MD.27770 | AL |
NPI | 1003024746 |
---|---|
Provider Name | Kerri Bevis |
First Address | Opelika, AL 36801-2381 |
Second Address | Opelika, AL 36801-2381 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 20/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00471021 | (05) | MS |
051103664 | BCBS (01) | AL |
051598131 | BCBS (01) | AL |
051598132 | BCBS (01) | AL |
102I983683 | (02) | |
110150 | (05) | AL |
110151 | (05) | AL |
127164 | (05) | AL |
130541 | (05) | AL |
P00854327 | RAILROAD MEDICARE (01) |