Provider Demographics
NPI:1760636807
Name:SEWARD VISION CLINIC, P.C.
Entity Type:Organization
Organization Name:SEWARD VISION CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SLEPICKA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:402-643-2944
Mailing Address - Street 1:236 S COLUMBIA AVE
Mailing Address - Street 2:PO BOX 129
Mailing Address - City:SEWARD
Mailing Address - State:NE
Mailing Address - Zip Code:68434-2206
Mailing Address - Country:US
Mailing Address - Phone:402-643-2944
Mailing Address - Fax:
Practice Address - Street 1:236 S COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:SEWARD
Practice Address - State:NE
Practice Address - Zip Code:68434-2206
Practice Address - Country:US
Practice Address - Phone:402-643-2944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-14
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1050152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE6161150001Medicare NSC