Beverly A Southerland in Lakeport - Physician Assistant
Beverly A Southerland - NPI 1376529891
Beverly A Southerland is a Physician Assistant in Lakeport, California. Beverly A Southerland practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Beverly A Southerland is 1376529891. The last update date is 2008-09-28.
Beverly A Southerland's current location address is 925 Bevins Ct, Lakeport, California. You can contact this provider via phone number 7072638322 and fax number 7072630329. The mailing address for Beverly A Southerland is 925 Bevins Ct, Lakeport, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Beverly A Southerland |
|---|---|
| Address | 925 Bevins Ct, Lakeport, California |
| Phone Number | 7072638322 |
| Fax Number | 7072630329 |
| Sole Proprietor | N |
| Credentials | P.A. |
NPI Number Detail
| NPI Number | 1376529891 |
|---|---|
| Provider Enumeration Date | 2005-12-16 |
| Last Updated Date | 2008-09-28 |
Provider Mailing Address Detail
| Address | 925 Bevins Ct |
|---|---|
| City | Lakeport |
| State | California (CA) |
| Post Code | 954539754 |
| Phone Number | 7072638322 |
| Fax Number | 7072630329 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA14213 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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What is the unique 10-digit identifier code issued to Beverly A Southerland by the Centers for Medicare & Medicaid Services?
The Beverly A Southerland has been assigned the NPI (National Provider Identifier) 1376529891 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Where is the Beverly A Southerland located?
The Beverly A Southerland is located at 925 Bevins Ct, Lakeport, CA 954539754.
What is Beverly A Southerland's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Beverly A Southerland is Physician Assistant, and the taxonomy classification code that categorizes this area of expertise is 363A00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1376529891 to Beverly A Southerland?
The Beverly A Southerland received its 1376529891 assignment from the Centers for Medicare & Medicaid Services on 2005-12-16.
When was the information regarding Beverly A Southerland most recently updated?
The details pertaining to the Beverly A Southerland, including its address, specialty, and other relevant information, were last refreshed on 2008-09-28.