Provider Demographics
NPI:1710903455
Name:BEGHIN, JOHN LOUIS (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:LOUIS
Last Name:BEGHIN
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 1:19841 N 27TH AVE
Mailing Address - Street 2:SUITE 300-A
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-4003
Mailing Address - Country:US
Mailing Address - Phone:623-582-2010
Mailing Address - Fax:623-582-9323
Practice Address - Street 1:19841 N 27TH AVE
Practice Address - Street 2:SUITE 300-A
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4003
Practice Address - Country:US
Practice Address - Phone:623-582-2010
Practice Address - Fax:623-582-9323
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ29670207XS0117X
IN01028925A207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B29541Medicare UPIN
AZZ67801Medicare PIN