Organization
MCLAIN OPTOMETRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GORDON GLEN MCLAIN O.D. (PRESIDENT)
(308) 220-4646
Entity
Organization
Contact information
Practice address
3322 AVENUE I, SCOTTSBLUFF, NE 69361-4589
(308) 220-4646
(308) 220-4548
Mailing address
3319 VERBENA PL, SCOTTSBLUFF, NE 69361-4520
(308) 641-7464
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
851 TPA 228
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025-0512-00
—
NE
Enumeration date
09/11/2006
Last updated
08/22/2020
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