Individual
TANNER CALVIN GATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5401 SOUTH ST, LINCOLN, NE 68506-2150
(402) 413-3531
(402) 413-3535
Mailing address
5401 SOUTH ST, LINCOLN, NE 68506-2150
(402) 413-3531
(402) 413-3535
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1362
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
096555007
MEDICARE PROVIDER NUMBER
NE
Enumeration date
07/07/2010
Last updated
01/03/2013
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