Provider Demographics
NPI:1083781777
Name:EYE PHYSICIANS, P.C.
Entity Type:Organization
Organization Name:EYE PHYSICIANS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:CONGDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-563-3686
Mailing Address - Street 1:428 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:DAVID CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68632-1627
Mailing Address - Country:US
Mailing Address - Phone:402-367-3895
Mailing Address - Fax:
Practice Address - Street 1:428 N 5TH ST
Practice Address - Street 2:
Practice Address - City:DAVID CITY
Practice Address - State:NE
Practice Address - Zip Code:68632-1627
Practice Address - Country:US
Practice Address - Phone:402-367-3895
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1147120003Medicare NSC