Provider Demographics
NPI:1265562995
Name:VOGL, LILIEN ANNA (OD)
Entity type:Individual
Prefix:DR
First Name:LILIEN
Middle Name:ANNA
Last Name:VOGL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10750 W MCDOWELL RD
Mailing Address - Street 2:BLDG A #100
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-5960
Mailing Address - Country:US
Mailing Address - Phone:623-877-3007
Mailing Address - Fax:623-877-4488
Practice Address - Street 1:10750 W MCDOWELL RD
Practice Address - Street 2:BLDG A #100
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-5960
Practice Address - Country:US
Practice Address - Phone:623-877-3007
Practice Address - Fax:623-877-4488
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ989152W00000X
IN18002331B152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZT82532Medicare UPIN
AZZ71841Medicare PIN