Individual
DR. CALVIN K BANCROFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
318 N MAIN ST, VALENTINE, NE 69201-1842
(402) 376-2020
(402) 376-1652
Mailing address
318 N MAIN ST, VALENTINE, NE 69201-1842
(402) 376-2020
(402) 376-1652
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
776
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06790
BLUE CROSS BLUE SHIELD
NE
01
—
229986
MIDLANDS CHOICE
—
05
—
47069297700
—
NE
01
—
9200950
SOUTH DAKOTA MEDICAID
SD
Enumeration date
11/02/2005
Last updated
11/27/2007
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