Individual
CARL W FIESER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2004 1ST AVE, STE A, DODGE CITY, KS 67801-2623
(620) 225-1033
(620) 227-8491
Mailing address
2004 1ST AVE, STE A, DODGE CITY, KS 67801-2623
(620) 225-1033
(620) 227-8491
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
04-16118
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100204750B
—
KS
05
—
200487030A
—
OK
05
—
6750056
—
CO
05
—
91161182
—
CO
01
—
CO40688
MEDICARE COLORADO
CO
01
—
KA1172003
MEDICARE
KS
01
—
KA1173003
MEDICARE
KS
Enumeration date
05/18/2006
Last updated
04/07/2017
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