Provider Demographics
NPI:1356656920
Name:KRUGLET, MICHAEL GALE (OD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:GALE
Last Name:KRUGLET
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8250 RAZORBACK RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3950
Mailing Address - Country:US
Mailing Address - Phone:719-260-8065
Mailing Address - Fax:
Practice Address - Street 1:8250 RAZORBACK RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3950
Practice Address - Country:US
Practice Address - Phone:719-260-8065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-08
Last Update Date:2010-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2801152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist