Individual
DIANE E BEGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 FERRY ST STE B, LAFAYETTE, IN 47901-1172
(765) 446-5161
(765) 446-5160
Mailing address
PO BOX 4699, LAFAYETTE, IN 47903-4699
(765) 449-2732
(765) 449-1196
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01040055A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000304622
ANTHEM PROVIDER NUMBER
IN
05
—
100464270
—
IN
01
—
10780247
CAQH
IN
01
—
P00077639
RAILROAD MEDICARE
IN
Enumeration date
03/14/2006
Last updated
03/22/2021
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