Basic Information
Provider Information
NPI: 1215961297
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RIGEL
FirstName: LEE
MiddleName: E.
NamePrefix: DR.
NameSuffix:  
Credential: O.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 310 W LAKE LANSING RD
Address2:  
City: EAST LANSING
State: MI
PostalCode: 488231438
CountryCode: US
TelephoneNumber: 5173378182
FaxNumber: 5173320038
Practice Location
Address1: 310 W LAKE LANSING RD
Address2:  
City: EAST LANSING
State: MI
PostalCode: 488231438
CountryCode: US
TelephoneNumber: 5173378182
FaxNumber: 5173320038
Other Information
ProviderEnumerationDate: 07/10/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
152W00000X4901002316MIY Eye and Vision Services ProvidersOptometrist 

No ID Information.


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