Provider Demographics
NPI:1023057429
Name:BIEGLER, LYLE W (MD)
Entity type:Individual
Prefix:
First Name:LYLE
Middle Name:W
Last Name:BIEGLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1460
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57402-1460
Mailing Address - Country:US
Mailing Address - Phone:605-225-0378
Mailing Address - Fax:605-225-7919
Practice Address - Street 1:105 S STATE ST.
Practice Address - Street 2:SUITE 113
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-4500
Practice Address - Country:US
Practice Address - Phone:605-225-5856
Practice Address - Fax:605-225-7919
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD7036207Q00000X
MN48246207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5612950Medicaid
SD5612952Medicaid
ND14823Medicaid
S102059Medicare PIN
SD5612952Medicaid
ND14823Medicaid