Provider Demographics
NPI:1427108836
Name:BIEGEL, KEVIN B (OD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:B
Last Name:BIEGEL
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 1:111 S 24TH ST W
Mailing Address - Street 2:SUITE 16
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-5600
Mailing Address - Country:US
Mailing Address - Phone:406-652-4141
Mailing Address - Fax:
Practice Address - Street 1:111 S 24TH ST W
Practice Address - Street 2:SUITE 16
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-5600
Practice Address - Country:US
Practice Address - Phone:406-652-4141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT556152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT483509Medicaid
MT25921OtherBLUE CROSS BLUE SHIELD
MT483509Medicaid
MTU33818Medicare UPIN