Provider Demographics
NPI:1891799672
Name:HSIEH, WING C (OD)
Entity Type:Individual
Prefix:DR
First Name:WING
Middle Name:C
Last Name:HSIEH
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 1:2462 CACTUS BLUFF PL
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-6453
Mailing Address - Country:US
Mailing Address - Phone:712-253-4840
Mailing Address - Fax:
Practice Address - Street 1:777 BANNOCK ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4507
Practice Address - Country:US
Practice Address - Phone:303-602-6000
Practice Address - Fax:303-602-2719
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1894152W00000X
CO0003661152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025032100Medicaid
IA6280081Medicaid
SD9201417Medicaid
SD9201415Medicaid
IA9280081Medicaid
MN130025300Medicaid
IA8280081Medicaid
SD9201419Medicaid
SD9201730Medicaid
SD9201418Medicaid
NE46044447400Medicaid
NE46044447400Medicaid
SD9201730Medicaid
SD102330Medicare PIN
IA8280081Medicaid
SD9201418Medicaid