Individual
LYNDON GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
9239 W CENTER RD, SUITE 103, OMAHA, NE 68124-1900
(402) 898-3232
(402) 898-3234
Mailing address
9239 W CENTER RD, STE 103, OMAHA, NE 68124-1900
(402) 898-3232
(402) 898-3234
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0601800388
VA
152W00000X
Optometrist
1387
LA
152W00000X
Optometrist
15201890
IA
152W00000X
Optometrist
2277
CO
152W00000X
Optometrist
2967T
OR
152W00000X
Optometrist
5659180-9934
UT
152W00000X
Optometrist
Primary
998
NE
152W00000X
Optometrist
OD00003880
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1473839
—
LA
05
—
2029544
—
WA
01
—
38550
BLUECROSS BLUESHIELD
IA
Enumeration date
05/12/2006
Last updated
04/30/2015
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