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Individual

DR. SHANE NICHOLAS VOGEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
2325 W 57TH ST, SIOUX FALLS, SD 57108-5046
(605) 275-6100
(605) 275-6105
Mailing address
2325 W 57TH ST, SIOUX FALLS, SD 57108-5046
(605) 275-6100
(605) 275-6105

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
02358
IA
152W00000X
Optometrist
Primary
685
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0218339
IA
01
18020
WELLMARK
IA
01
421497917
COMMERCIAL & OTHER STATES
IA
01
A004235
CHAMPUS
IA
Enumeration date
08/29/2006
Last updated
10/16/2012
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