Organization
LYNDON GRAVES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNDON JAY GRAVES O.D. (OWNER/OPTOMETRIST)
(402) 898-3232
Entity
Organization
Contact information
Practice address
9239 W CENTER RD, SUITE 103, OMAHA, NE 68124-1933
(402) 898-3232
(402) 898-3234
Mailing address
9239 W CENTER RD, SUITE 103, OMAHA, NE 68124-1933
(402) 898-3232
(402) 898-3234
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
998
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0432161
—
IA
05
—
1151289
—
LA
05
—
2029544
—
WA
05
—
7100151470
—
KY
05
—
G20027930A
—
OK
Enumeration date
05/10/2006
Last updated
03/23/2011
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