Provider Demographics
NPI:1649222936
Name:NANCY A DOB, OD, PC
Entity type:Organization
Organization Name:NANCY A DOB, OD, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:A
Authorized Official - Last Name:DOB
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:402-362-3313
Mailing Address - Street 1:625 LINCOLN AVE
Mailing Address - Street 2:PO BOX 238
Mailing Address - City:YORK
Mailing Address - State:NE
Mailing Address - Zip Code:68467-2946
Mailing Address - Country:US
Mailing Address - Phone:402-362-3313
Mailing Address - Fax:402-362-1533
Practice Address - Street 1:625 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:NE
Practice Address - Zip Code:68467-2946
Practice Address - Country:US
Practice Address - Phone:402-362-3313
Practice Address - Fax:402-362-1533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========Medicaid
NE098568Medicare PIN
NE0183380001Medicare NSC