Provider Demographics
NPI:1902943335
Name:KRIEGER, PERRY L (OD)
Entity Type:Individual
Prefix:DR
First Name:PERRY
Middle Name:L
Last Name:KRIEGER
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 1:6301 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-5200
Mailing Address - Country:US
Mailing Address - Phone:319-268-1966
Mailing Address - Fax:319-268-1957
Practice Address - Street 1:6301 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-5200
Practice Address - Country:US
Practice Address - Phone:319-268-1966
Practice Address - Fax:319-268-1957
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01835152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA06087OtherWELLMARK PROVIDER #
IA06087OtherDR. KRIEGER NONBILLING #
IA06086Medicare ID - Type UnspecifiedGROUP MEDICARE #
IAT01429Medicare UPIN