Provider Demographics
NPI:1285636530
Name:FILIPS, ROGER F (OD)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:F
Last Name:FILIPS
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 1:202 S ROBINSON AVE
Mailing Address - Street 2:
Mailing Address - City:HARTINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68739-5501
Mailing Address - Country:US
Mailing Address - Phone:402-254-2020
Mailing Address - Fax:402-254-2020
Practice Address - Street 1:202 S ROBINSON AVE
Practice Address - Street 2:
Practice Address - City:HARTINGTON
Practice Address - State:NE
Practice Address - Zip Code:68739-5501
Practice Address - Country:US
Practice Address - Phone:402-254-2020
Practice Address - Fax:402-254-2020
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE914152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47087547412Medicaid
NE06816OtherBC/BS
NE47-087547413Medicaid
NE6897OtherBC/BS
NE6897OtherBC/BS
NE06816OtherBC/BS
NET40325Medicare UPIN
NE47087547412Medicaid
NE47-087547413Medicaid