RYAN WIDDISON (NPI# 1639552169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639552169 |
| Entity Type | Individual |
| Full Name | RYAN WIDDISON |
| Credential | O.D. |
| Practice Address |
1925 Florence Ave Kingman AZ 86401-4617 |
| Practice Telephone | 9287532106 |
| Practice Fax Number | 9287534283 |
| Mailing Telephone | 9287532106 |
| Mailing Fax Number | 9287534283 |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2015-07-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2066 | AZ | Eye and Vision Services Providers |
| Street Address |
1925 FLORENCE AVE |
| City | KINGMAN |
| State | AZ |
| Zip Code | 86401-4617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447232590 | Scott David Mullane | Optometrist | 1925 Florence Ave, Kingman, AZ 86401-4617 | 2005-11-15 |
| 1275085284 | Mohave Eye Center, Ltd | Optometrist | 1925 Florence Ave, Kingman, AZ 86401-4617 | 2016-10-26 |
| 1861691586 | Jeffrey Parke Bergeson | Optometrist | 1925 Florence Ave, Kingman, AZ 86401-4617 | 2007-07-12 |
| 1063438257 | Mohave Eye Centers Ltd | Ophthalmology | 1925 Florence Ave, Kingman, AZ 86401-4617 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053858704 | Robert Cole | Nurse Practitioner | 3545 Cheyenne Ave, King,an, AZ 86401 | 2017-01-19 |
| 1710420286 | Acadia Healthcare Inc | Nurse Practitioner | 2699 E Andy Devine, Suite B, Kingman, AZ 86401 | 2016-11-30 |
| 1174079800 | Kenneth Mcadow | Physical Therapist | 2404 Stockton Hill Road, Suite K, Kingman, AZ 86401 | 2016-09-01 |
| 1649659483 | Tracie Hirz | Case Manager/Care Coordinator | 3656 Packsaddle Road, Kingman, AZ 86401 | 2015-05-27 |
| 1548657695 | Chelsea Presbrey | Family Medicine | 2202 N Stockton Hill Rd Ste 100, Kingman, AZ 86401 | 2015-04-15 |
| 1649617226 | Abubakr Abdelmunim Tagelsir Abdelaziz | Internal Medicine | 2501 N Stockton Hill Rd Ste 102, Kingman, AZ 86401 | 2013-05-23 |
| 1205173325 | Patricia Jean Marko | Social Worker | 2002 Stockton Hill Road, Mohave Mental Health Clinic, Inc., Kingman, AZ 86401 | 2013-01-09 |
| 1770835316 | Hae Young Lee | Dentist | 2058 Maya Dr., Kingman, AZ 86401 | 2012-10-05 |
| 1255681623 | Hilary Radler | Specialist/Technologist | 3033 Macdonald, Kingman, AZ 86401 | 2012-09-13 |
| 1477836880 | Goodwill of Northern Arizona | Exclusive Provider Organization | 2369 Airway Avenue, Kingman, AZ 86401 | 2011-09-21 |
| Find all providers in zip 86401 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356638662 | Maydew Thibault Optometry LLC | Optometrist | 104 West C Ave, Kingman, KS 67068-1313 | 2011-07-07 |
| 1902098007 | Kelly John Corbridge | Optometrist | 2187 Airway Ave., Kingman, AZ 86409-3669 | 2007-08-13 |
| 1649488909 | Wybrow Eyecare PC | Optometrist | 3941 E Packard Ave, Kingman, AZ 86409-0857 | 2007-05-18 |
| 1689630832 | Desert Family Eye Center, P.C. | Optometrist | 2187 Airway Ave, Kingman, AZ 86409-3669 | 2006-04-25 |
| 1447232590 | Scott David Mullane | Optometrist | 1925 Florence Ave, Kingman, AZ 86401-4617 | 2005-11-15 |
| 1275085284 | Mohave Eye Center, Ltd | Optometrist | 1925 Florence Ave, Kingman, AZ 86401-4617 | 2016-10-26 |
| 1689921553 | Andrew W Piester | Optometrist | 104 West C Ave, Kingman, KS 67068-1313 | 2012-08-10 |
| 1861691586 | Jeffrey Parke Bergeson | Optometrist | 1925 Florence Ave, Kingman, AZ 86401-4617 | 2007-07-12 |
| 1265552046 | Marie-there Yvonne Broca | Optometrist | 3396 N Stockton Hill Rd, Kingman, AZ 86409-3648 | 2007-03-29 |
| 1316996895 | Kevin Jay Wogalter | Optometrist | 2215 E Hualapai Mountain Rd, Kingman, AZ 86401-8324 | 2006-05-10 |
| Find all providers in KINGMAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.