Provider Demographics
NPI:1306894746
Name:MURSCHEL, DENNIS L (OD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:L
Last Name:MURSCHEL
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 1:1402 W 41ST ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-6316
Mailing Address - Country:US
Mailing Address - Phone:605-338-1873
Mailing Address - Fax:605-332-5041
Practice Address - Street 1:1402 W 41ST ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-6316
Practice Address - Country:US
Practice Address - Phone:605-338-1873
Practice Address - Fax:605-332-5041
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDT147152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9200600Medicaid
SD410007963OtherMEDICARE RAILROAD
SD0075005OtherBLUE CROSS BLUE SHIELD
SDS75005Medicare PIN
SD0075005OtherBLUE CROSS BLUE SHIELD
SD9200600Medicaid