Provider Demographics
NPI:1699223792
Name:BRIAN PIEPER, O.D. P.C.
Entity type:Organization
Organization Name:BRIAN PIEPER, O.D. P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAILA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAIRSCEY
Authorized Official - Suffix:
Authorized Official - Credentials:CPOC
Authorized Official - Phone:307-745-8554
Mailing Address - Street 1:819 W MAPLE ST
Mailing Address - Street 2:UNIT B
Mailing Address - City:RAWLINS
Mailing Address - State:WY
Mailing Address - Zip Code:82301-5462
Mailing Address - Country:US
Mailing Address - Phone:307-324-2219
Mailing Address - Fax:
Practice Address - Street 1:819 W MAPLE ST
Practice Address - Street 2:UNIT B
Practice Address - City:RAWLINS
Practice Address - State:WY
Practice Address - Zip Code:82301-5462
Practice Address - Country:US
Practice Address - Phone:307-324-2219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-17
Last Update Date:2016-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY343T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty