Provider Demographics
NPI:1174505762
Name:BEGGERLY, CLAY E (MD)
Entity type:Individual
Prefix:
First Name:CLAY
Middle Name:E
Last Name:BEGGERLY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5880 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8220
Mailing Address - Country:US
Mailing Address - Phone:515-633-3835
Mailing Address - Fax:515-633-3837
Practice Address - Street 1:800 KENYON RD
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-5776
Practice Address - Country:US
Practice Address - Phone:515-574-6840
Practice Address - Fax:515-576-7726
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2008-02-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA30284208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0117887Medicaid
IA0117887Medicaid
IAE86743Medicare UPIN