Provider Demographics
NPI:1437218476
Name:KEARNEY EYE INSTITUTE, P.C.
Entity Type:Organization
Organization Name:KEARNEY EYE INSTITUTE, P.C.
Other - Org Name:GRAND ISLAND EYE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-865-2760
Mailing Address - Street 1:411 W 39TH ST.
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845
Mailing Address - Country:US
Mailing Address - Phone:308-865-2760
Mailing Address - Fax:308-865-2769
Practice Address - Street 1:411 W 39TH ST.
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845
Practice Address - Country:US
Practice Address - Phone:308-865-2760
Practice Address - Fax:308-865-2769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE01975OtherBCBS #
NE01975OtherBCBS #
098106Medicare PIN
NE01975OtherBCBS #