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General NPI Number Information
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NPI Number | 1306865282
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Entity Type | Organization
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Legal Business Name | PAUL NIEGSCH OD LLC
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 12/15/2022
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Provider Practice Location Address
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Address Line | 101 N BROADWAY ST STE A
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City | PITTSBURG
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State | KS
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Zip | 66762-4804
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Country | US
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Telephone | 620-232-3277
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 186 101 N BROADWAY STE A
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City | PITTSBURG
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State | KS
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Zip | 66762-0186
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Country | US
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Telephone | 620-232-3277
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL NIEGSCH
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Credential | O D
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Telephone | 620-232-3277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1242-3
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License Number State | KS
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