Provider Demographics
NPI:1376981142
Name:MIES, CHAD STEVEN (OD)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:STEVEN
Last Name:MIES
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 1:1401 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:KS
Mailing Address - Zip Code:66067-3528
Mailing Address - Country:US
Mailing Address - Phone:785-242-4242
Mailing Address - Fax:785-242-7885
Practice Address - Street 1:1401 S MAIN ST
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:KS
Practice Address - Zip Code:66067-3528
Practice Address - Country:US
Practice Address - Phone:785-242-4242
Practice Address - Fax:785-242-7885
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1949152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist