Healthcare Provider Details

I. General information

NPI: 1023360047
Provider Name (Legal Business Name): RYAN DUGAN EYE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2012
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 ANDALE RD
ANDALE KS
67001-9656
US

IV. Provider business mailing address

228 ANDALE RD
ANDALE KS
67001-9656
US

V. Phone/Fax

Practice location:
  • Phone: 316-444-2000
  • Fax: 316-445-2600
Mailing address:
  • Phone: 316-444-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1939
License Number StateKS

VIII. Authorized Official

Name: DR. RYAN MICHAEL DUGAN
Title or Position: OWNER
Credential: O.D.
Phone: 316-393-8872