MEDICARE: RONALD L. FIEGEL, O.D., P.A.

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

General Provider Information

NPI Number	:	1710194832
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RONALD L. FIEGEL, O.D., P.A.

Provider Business Mailing Address
First Line	:	2230 N RIDGE RD
Second Line	:	SUITE E
City	:	WICHITA
State	:	KS
Zip	:	67205-1053
Country	:	US
Telephone Number	:	316-729-8900
Fax Number	:	316-729-9824

Provider Business Practice Location Address
First Line	:	2230 N RIDGE RD
Second Line	:	SUITE E
City	:	WICHITA
State	:	KS
Zip	:	67205-1053
Country	:	US
Telephone Number	:	316-729-8900
Fax Number	:	316-729-9824

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. RONALD L. FIEGEL
Credential	:	O.D., P.A.
Telephone Number	:	316-729-8900

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	01/15/2008

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