Individual
DR. BRECKENRIDGE CHARLES DILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D
Contact information
Practice address
3012 ANDERSON AVE, MANHATTAN, KS 66503-2809
(785) 537-1118
(785) 537-8005
Mailing address
2800 SW WANAMAKER RD, SUITE 192, TOPEKA, KS 66614-4293
(785) 272-0707
(785) 271-1512
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
KS-1546
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100361140C
—
KS
01
—
410048649
RAILROAD MEDICARE
KS
01
—
650723
BCBS
—
01
—
650771
BCBS
—
Enumeration date
11/08/2005
Last updated
07/01/2008
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