MEDICARE: RACHEL SIEGEL OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	6317	OH

General Provider Information

NPI Number	:	1366856981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL SIEGEL OD

Provider Business Mailing Address
First Line	:	5320 E MAIN ST STE 100
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43213-2573
Country	:	US
Telephone Number	:	614-863-1433
Fax Number	:

Provider Business Practice Location Address
First Line	:	5320 E MAIN ST STE 100
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43213-2573
Country	:	US
Telephone Number	:	614-863-1433
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2014
Last Update Date	:	02/23/2017

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