Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 1803 | KS |
N | 152W00000X | Optometrist | 2696 | CO |
NPI | 1003062316 |
---|---|
Provider Name | Philip Beggs |
First Address | Wichita, KS 67205-7350 |
Second Address | Wichita, KS 67205-7350 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2008 |
Last Update Date | 19/09/2014 |