Individual
DR. JEFFREY W SANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
408 S 8TH AVE, BROKEN BOW, NE 68822-2009
(308) 872-2291
(308) 872-3122
Mailing address
PO BOX 506, BROKEN BOW, NE 68822-0506
(308) 872-2291
(308) 872-3122
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1015
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36012
MIDLANDS
NE
01
—
37064
BCBS OF NE
NE
01
—
410018187
RAILROAD INDIV PROVIDER #
NE
05
—
47077269013
—
NE
01
—
6719
BLUE CROSS BLUE SHIELD NE
NE
01
—
P00603623
RR MEDICARE
NE
05
—
SSN00
—
NE
Enumeration date
11/02/2005
Last updated
04/16/2013
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