1598740847 NPI number — JEFFREY A BEGG O.D.

Table of content: JEFFREY A BEGG O.D. (NPI 1598740847)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598740847 NPI number — JEFFREY A BEGG O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BEGG
Provider First Name:
JEFFREY
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
O.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598740847
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/16/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
259 OLD ROUTE 30
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
GREENSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15601-6992
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-836-1230
Provider Business Mailing Address Fax Number:
724-836-5227

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
259 OLD ROUTE 30
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-6992
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-836-1230
Provider Business Practice Location Address Fax Number:
724-836-5227
Provider Enumeration Date:
12/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  OEG000439 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01916621 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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