Logan Banister, O.D

NPI 1154551828 · on the registry since 2009 · sole proprietor

Practice

Address: 1626 E Madison Ave
Derby, KS 67037
Phone: (316) 788-1535
Fax: (316) 788-1596
Organisation at this address: Derby Eyecare Llc
Dr. Richard Marks
Ronald L Fiegel Od Pa- Derby
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy: 152W00000X
152W00000X
Licence states on file: KS
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2009-08-28

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Kansas