Provider Demographics
NPI:1134291479
Name:BEGAY, ROSALINE (INTERNAL MEDICINE)
Entity Type:Individual
Prefix:MS
First Name:ROSALINE
Middle Name:
Last Name:BEGAY
Suffix:
Gender:F
Credentials:INTERNAL MEDICINE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO DRAWER PH
Mailing Address - Street 2:
Mailing Address - City:CHINLE
Mailing Address - State:AZ
Mailing Address - Zip Code:86503
Mailing Address - Country:US
Mailing Address - Phone:928-674-7001
Mailing Address - Fax:928-674-7705
Practice Address - Street 1:NAVAJO ROUTE 64
Practice Address - Street 2:
Practice Address - City:TSAILE
Practice Address - State:AZ
Practice Address - Zip Code:86556
Practice Address - Country:US
Practice Address - Phone:928-724-3600
Practice Address - Fax:928-724-3605
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28159207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ565161Medicaid
AZH53073Medicare UPIN
AZ8HE487Medicare ID - Type UnspecifiedMEDICARE PART B - PINON
AZ8HE488Medicare ID - Type UnspecifiedMEDICARE PART B - TSAILE
AZ565161Medicaid