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NPI Code Detail

MEDICARE: RAND W SIEKERT OD

MEDICARE: RAND W SIEKERT 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
1152W00000XOptometrist931AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902978372
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAND W SIEKERT OD
Provider Business Mailing Address
First Line : 575 E RIVER RD
Second Line :
City : TUCSON
State : AZ
Zip : 85704-5822
Country : US
Telephone Number : 520-874-7400
Fax Number : 520-874-3425
Provider Business Practice Location Address
First Line : 707 N ALVERNON WAY STE 301
Second Line :
City : TUCSON
State : AZ
Zip : 85711-1848
Country : US
Telephone Number : 520-694-1460
Fax Number : 520-694-1464
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2006
Last Update Date : 07/08/2007

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