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Individual

DR. PHILIP LYLE GILDERSLEEVE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
856
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00410801
RR MEDICARE
NE
Enumeration date
09/20/2006
Last updated
11/15/2007
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