Provider Demographics
NPI:1649442450
Name:BEGAY, VINCENT
Entity type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:
Last Name:BEGAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3863
Mailing Address - Street 2:
Mailing Address - City:WINDOW ROCK
Mailing Address - State:AZ
Mailing Address - Zip Code:86515-3863
Mailing Address - Country:US
Mailing Address - Phone:323-988-7117
Mailing Address - Fax:323-988-7117
Practice Address - Street 1:RURAL ADDRESS 6220, ROUTE 12
Practice Address - Street 2:MILE POST 60.3
Practice Address - City:TSAILE
Practice Address - State:AZ
Practice Address - Zip Code:86556
Practice Address - Country:US
Practice Address - Phone:323-988-7117
Practice Address - Fax:323-988-7117
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor