Provider Demographics
NPI:1427064757
Name:RIES, JAMES DARIN (OD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:DARIN
Last Name:RIES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:202 OCONNELL
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MARSHALL
Mailing Address - State:MN
Mailing Address - Zip Code:56258
Mailing Address - Country:US
Mailing Address - Phone:507-532-5777
Mailing Address - Fax:507-532-2087
Practice Address - Street 1:107 1ST STREET EAST
Practice Address - Street 2:
Practice Address - City:CANBY
Practice Address - State:MN
Practice Address - Zip Code:56220
Practice Address - Country:US
Practice Address - Phone:507-223-5818
Practice Address - Fax:507-223-7737
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN2670152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN163J9RIOtherBCBS OF MN
MN163J4RIOtherBCBS BLUE PLUS OF MN
MN163J9RIOtherBCBS BLUE PLUS OF MN
MN164J4RIOtherBCBS OF MN
MN164J4RIOtherBCBS BLUE PLUS OF MN
MN2200501OtherMEDICA
SD9203188OtherSOUTH DAKOTA MEDICAID
MN163J4RIOtherBCBS OF MN
MN2200502OtherMEDICA
MN123165OtherUCARE MN
MN2200503OtherMEDICA
MN774451025290OtherPREFERRED ONE
MN774471025290OtherPREFERRED ONE
MN781101025290OtherPREFERRED ONE
MN2200502OtherMEDICA