Provider Demographics
NPI:1700030806
Name:RONALD L FIEGEL OD PA- DERBY
Entity Type:Organization
Organization Name:RONALD L FIEGEL OD PA- DERBY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:FIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:316-729-8900
Mailing Address - Street 1:1626 E MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:KS
Mailing Address - Zip Code:67037-2076
Mailing Address - Country:US
Mailing Address - Phone:316-788-1535
Mailing Address - Fax:316-788-1596
Practice Address - Street 1:1626 E MADISON AVE
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:KS
Practice Address - Zip Code:67037-2076
Practice Address - Country:US
Practice Address - Phone:316-788-1535
Practice Address - Fax:316-788-1596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-17
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1082-3152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty