Provider Demographics
NPI:1003062316
Name:BEGGS, PHILIP (OD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:BEGGS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2357 N MAIZE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-7350
Mailing Address - Country:US
Mailing Address - Phone:316-558-8151
Mailing Address - Fax:316-558-8044
Practice Address - Street 1:2357 N MAIZE RD STE 103
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-7350
Practice Address - Country:US
Practice Address - Phone:316-558-8151
Practice Address - Fax:316-558-8044
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1803152W00000X
CO2696152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS017162001Medicare PIN