Individual
DANIEL A GILLOGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1821 E MADISON AVE, SUITE 1600, DERBY, KS 67037-2357
(316) 789-8383
(316) 789-0336
Mailing address
1851 N WEBB RD, ATTN FLR2, WICHITA, KS 67206-3413
(316) 636-2010
(316) 858-3830
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1327-3
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100219560C
—
KS
01
—
410029920
RAILROAD MEDICARE
KS
Enumeration date
03/08/2006
Last updated
11/16/2021
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