Provider Demographics
NPI:1053316679
Name:FIEGEL, RONALD L (OD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:L
Last Name:FIEGEL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2230 N RIDGE RD
Mailing Address - Street 2:STE E
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-1053
Mailing Address - Country:US
Mailing Address - Phone:316-729-8900
Mailing Address - Fax:316-729-9824
Practice Address - Street 1:2230 N RIDGE RD
Practice Address - Street 2:STE E
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1053
Practice Address - Country:US
Practice Address - Phone:316-729-8900
Practice Address - Fax:316-729-9824
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSKS1082-3152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS275OtherPREFERRED HEALTH CARE INS
KS0342550001OtherDMERC SUPPLIER NUMBER
KSCH3879OtherRAIL ROAD MEDICARE
KS018092OtherBCBSKS
KS416390OtherFIRST GUARD
KS275OtherPREFERRED HEALTH CARE INS
KSCH3879OtherRAIL ROAD MEDICARE