Basic Information
Provider Information
NPI: 1619178167
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BEGGS
FirstName: DANA
MiddleName: D.
NamePrefix: MS.
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 617 N SPRUCE ST
Address2:  
City: LITTLE ROCK
State: AR
PostalCode: 722053749
CountryCode: US
TelephoneNumber: 5012022685
FaxNumber: 5012022003
Practice Location
Address1: 9601 INTERSTATE 630 EXIT 7
Address2: BAPTIST HEALTH MEDICAL CENTER
City: LITTLE ROCK
State: AR
PostalCode: 722057299
CountryCode: US
TelephoneNumber: 5012022685
FaxNumber: 5012022003
Other Information
ProviderEnumerationDate: 05/31/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X653ARY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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