Healthcare Provider Details

I. General information

NPI: 1780895490
Provider Name (Legal Business Name): JEFFREY D SIGLER R.PH.,CDM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 12/20/2019
Certification Date: 12/20/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4525 W 6TH ST SUITE 104
LAWRENCE KS
66049-4815
US

IV. Provider business mailing address

PO BOX 3578
LAWRENCE KS
66046-0578
US

V. Phone/Fax

Practice location:
  • Phone: 785-842-1225
  • Fax: 785-841-6297
Mailing address:
  • Phone: 785-749-5259
  • Fax: 785-749-5260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2-09997
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number2-09997
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: