Provider Demographics
NPI:1851378004
Name:HARSHMAN, DOUG A (OD)
Entity Type:Individual
Prefix:DR
First Name:DOUG
Middle Name:A
Last Name:HARSHMAN
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:68510-2500
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:68510-2500
Practice Address - Country:US
Practice Address - Phone:402-420-2020
Practice Address - Fax:402-323-2002
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NENE1338152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE0553580001Medicare NSC
NE095804002Medicare PIN
U90442Medicare UPIN