Provider Demographics
NPI:1104177104
Name:DUGAN, RYAN MICHAEL (OD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:MICHAEL
Last Name:DUGAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 N ANDALE RD
Mailing Address - Street 2:
Mailing Address - City:ANDALE
Mailing Address - State:KS
Mailing Address - Zip Code:67001-9656
Mailing Address - Country:US
Mailing Address - Phone:316-444-2000
Mailing Address - Fax:
Practice Address - Street 1:228 ANDALE RD
Practice Address - Street 2:
Practice Address - City:ANDALE
Practice Address - State:KS
Practice Address - Zip Code:67001-9656
Practice Address - Country:US
Practice Address - Phone:316-393-8872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-01
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1939152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist