Provider Demographics
NPI:1184646127
Name:BOEVER, JOHN NEUMANN (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:NEUMANN
Last Name:BOEVER
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 1:6845 S 27TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68512-4823
Mailing Address - Country:US
Mailing Address - Phone:402-420-6644
Mailing Address - Fax:402-420-2926
Practice Address - Street 1:6845 S 27TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68512-4823
Practice Address - Country:US
Practice Address - Phone:402-420-6644
Practice Address - Fax:402-420-2926
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1255152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist