Provider Demographics
NPI:1952396632
Name:BEGLINGER, LEIGH J (PHD)
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:J
Last Name:BEGLINGER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-335-8765
Mailing Address - Fax:319-353-3003
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-335-8765
Practice Address - Fax:319-353-3003
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00443103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA08501OtherWELLMARK BCBS
Q08954Medicare UPIN
IAP00171645Medicare PIN
IAI11352Medicare PIN