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Organization

ONEILL FAMILY EYECARE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PHILIP LYLE GILDERSLEEVE O.D. (PRESIDENT)
(402) 336-2220
Entity
Organization

Contact information

Practice address
612 N 4TH ST, ONEILL, NE 68763-1326
(402) 336-2220
(402) 336-4845
Mailing address
612 N 4TH ST, P.O. BOX 818, ONEILL, NE 68763-1326
(402) 336-2220
(402) 336-4845

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DG0428
RR MEDICARE
NE
Enumeration date
01/12/2007
Last updated
06/18/2010
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