Provider Demographics
NPI:1912091554
Name:DRS. KINCAID AND FETT
Entity Type:Organization
Organization Name:DRS. KINCAID AND FETT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:R
Authorized Official - Last Name:FETT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:402-494-5533
Mailing Address - Street 1:1000 W 29TH ST
Mailing Address - Street 2:STE 302
Mailing Address - City:SOUTH SIOUX CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68776
Mailing Address - Country:US
Mailing Address - Phone:402-494-5533
Mailing Address - Fax:402-494-5534
Practice Address - Street 1:1000 W 29TH ST
Practice Address - Street 2:STE 302
Practice Address - City:SOUTH SIOUX CITY
Practice Address - State:NE
Practice Address - Zip Code:68776
Practice Address - Country:US
Practice Address - Phone:402-494-5533
Practice Address - Fax:402-494-5534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid
NE=========00Medicaid
NE0392900001Medicare NSC