Healthcare Provider Details

I. General information

NPI: 1811125156
Provider Name (Legal Business Name): CHRIS ALLEN BEGGS CST, COF
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2009
Last Update Date: 10/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1532 LONE OAK RD SUITE 310
PADUCAH KY
42003-7913
US

IV. Provider business mailing address

1532 LONE OAK RD SUITE 310
PADUCAH KY
42003-7913
US

V. Phone/Fax

Practice location:
  • Phone: 270-217-7915
  • Fax: 270-441-4830
Mailing address:
  • Phone: 270-217-7915
  • Fax: 270-441-4830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number13798
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License NumberC50155
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: