NPI Code Detail JSON Logo

1902855414 NPI number — GUY ANDREW DIETELS O.D.

NPI Number: 1902855414
Health Care Provider/Practitioner: GUY ANDREW DIETELS O.D.

Information about “1902855414” NPI (GUY ANDREW DIETELS O.D.) exists in 1902855414 in HTML format HTML  |  1902855414 in plain Text format TXT  |  1902855414 in PDF (Portable Document Format) PDF  |  1902855414 in an XML format XML  formats.

NPI Number : 1902855414 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1902855414",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DIETELS",
    "FirstName": "GUY",
    "MiddleName": "ANDREW",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "O.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "75 BITTERSWEET LN",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HARDY",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "24101-3333",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "540-427-0567",
    "MailingAddressFaxNumber": "540-427-4367",
    "FirstLinePracticeLocationAddress": "1455 TOWNE SQUARE BLVD NW",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ROANOKE",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "24012-1612",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "540-265-0595",
    "PracticeLocationAddressFaxNumber": "540-265-0596",
    "EnumerationDate": "05/10/2006",
    "LastUpdateDate": "07/18/2008",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "152WC0802X",
        "TaxonomyName": "Corneal and Contact Management Optometrist",
        "LicenseNumber": "061800456",
        "LicenseNumberStateCode": "VA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.