Individual
JILL MICHELLE BEAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
4520 WATERMELON RD, NORTHPORT, AL 35473-5246
(205) 752-7443
(205) 556-8868
Mailing address
2731 MLK JR. BLVD, TUSCALOOSA, AL 35401-5235
(205) 349-3250
(205) 345-3993
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA.787
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA.787
PA LICENSE
AL
Enumeration date
01/30/2012
Last updated
06/23/2025
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