Provider Demographics
NPI:1316020613
Name:LINCOLN VISION CENTER PC
Entity Type:Organization
Organization Name:LINCOLN VISION CENTER PC
Other - Org Name:WAHOO VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:ARNESON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:402-443-3168
Mailing Address - Street 1:739 W 10TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:WAHOO
Mailing Address - State:NE
Mailing Address - Zip Code:68066-1102
Mailing Address - Country:US
Mailing Address - Phone:402-443-3168
Mailing Address - Fax:402-443-4176
Practice Address - Street 1:739 W 10TH ST STE A
Practice Address - Street 2:
Practice Address - City:WAHOO
Practice Address - State:NE
Practice Address - Zip Code:68066-1133
Practice Address - Country:US
Practice Address - Phone:402-443-3168
Practice Address - Fax:402-443-4176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1020152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NECB4714OtherRAILROAD MEDICARE
7578240001Medicare NSC