Provider Demographics
NPI:1851626378
Name:DR. CRAIG BEGIN AND ASSOCIATES LLC
Entity Type:Organization
Organization Name:DR. CRAIG BEGIN AND ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:GERALD
Authorized Official - Last Name:BEGIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:615-497-7071
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:907-522-9557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-16
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKOPT T 292152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1021258Medicaid
AK1021258Medicaid