Provider Demographics
NPI:1982681318
Name:MEYER, RICHARD W (OD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:W
Last Name:MEYER
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 1:2501 W BENJAMIN AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-3119
Mailing Address - Country:US
Mailing Address - Phone:402-371-3158
Mailing Address - Fax:402-371-3466
Practice Address - Street 1:2501 W BENJAMIN AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-3119
Practice Address - Country:US
Practice Address - Phone:402-371-3158
Practice Address - Fax:402-371-3466
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1157152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47082635803Medicaid
NE06786OtherBLUE CROSS BLUE SHIELD
NE06786OtherBLUE CROSS BLUE SHIELD
NE272995Medicare ID - Type Unspecified