Provider Demographics
NPI:1518021682
Name:BEGIN, CRAIG GERALD (OD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:GERALD
Last Name:BEGIN
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 1:5420 E 104TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-6814
Mailing Address - Country:US
Mailing Address - Phone:615-497-7071
Mailing Address - Fax:
Practice Address - Street 1:800 E DIMOND BLVD
Practice Address - Street 2:SUITE 3-138
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-2039
Practice Address - Country:US
Practice Address - Phone:907-522-9113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK292152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1023199Medicaid
AK1023199Medicaid