Provider Demographics
NPI:1982789889
Name:FINN, GARY D (OD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:D
Last Name:FINN
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 1:1526 WASHINGTON ST
Mailing Address - Street 2:STE A
Mailing Address - City:BLAIR
Mailing Address - State:NE
Mailing Address - Zip Code:68008-1600
Mailing Address - Country:US
Mailing Address - Phone:402-426-2119
Mailing Address - Fax:402-426-2120
Practice Address - Street 1:1526 WASHINGTON ST
Practice Address - Street 2:STE A
Practice Address - City:BLAIR
Practice Address - State:NE
Practice Address - Zip Code:68008-1600
Practice Address - Country:US
Practice Address - Phone:402-426-2119
Practice Address - Fax:402-426-2120
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE818152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47059001200Medicaid
NE47059001200Medicaid
NE094091Medicare ID - Type Unspecified