Healthcare Provider Details

I. General information

NPI: 1023057429
Provider Name (Legal Business Name): LYLE W BIEGLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 11/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 S STATE ST. SUITE 113
ABERDEEN SD
57401-4500
US

IV. Provider business mailing address

PO BOX 1460
ABERDEEN SD
57402-1460
US

V. Phone/Fax

Practice location:
  • Phone: 605-225-5856
  • Fax: 605-225-7919
Mailing address:
  • Phone: 605-225-0378
  • Fax: 605-225-7919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number48246
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number7036
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: