Organization
PAUL NIEGSCH OD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL NIEGSCH O D (OWNER)
(620) 232-3277
Entity
Organization
Contact information
Practice address
101 N BROADWAY ST STE A, PITTSBURG, KS 66762-4804
(620) 232-3277
Mailing address
PO BOX 186, 101 N BROADWAY STE A, PITTSBURG, KS 66762-0186
(620) 232-3277
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1242-3
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100218450B
—
KS
01
—
410049751
RAILROAD MEDICARE
KS
01
—
650551
BLUE CROSS BLUE SHIELD
KS
Enumeration date
07/19/2006
Last updated
12/15/2022
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