Provider Demographics
NPI:1407876600
Name:BRIGHTMAN, BRIAN D (OD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:D
Last Name:BRIGHTMAN
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 1:7930 O ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510
Mailing Address - Country:US
Mailing Address - Phone:402-420-2020
Mailing Address - Fax:402-323-2002
Practice Address - Street 1:7930 O ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510
Practice Address - Country:US
Practice Address - Phone:402-420-2020
Practice Address - Fax:402-323-2002
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2009-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1185152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE37062OtherBCBS
NEU90416Medicare UPIN
NE278910Medicare ID - Type Unspecified