Provider Demographics
NPI:1679519698
Name:BEGLEY, CHARLES JEFF (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:JEFF
Last Name:BEGLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 15TH ST NW
Mailing Address - Street 2:SUITE 303
Mailing Address - City:NORTON
Mailing Address - State:VA
Mailing Address - Zip Code:24273-1627
Mailing Address - Country:US
Mailing Address - Phone:276-439-1280
Mailing Address - Fax:276-439-1281
Practice Address - Street 1:102 15TH ST NW
Practice Address - Street 2:SUITE 303
Practice Address - City:NORTON
Practice Address - State:VA
Practice Address - Zip Code:24273-1627
Practice Address - Country:US
Practice Address - Phone:276-439-1280
Practice Address - Fax:276-439-1281
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101039639208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1521160Medicaid
VA1679519698Medicaid
KY6466503700Medicaid
VA00X674N20Medicare PIN
TN1521160Medicaid