Individual
MATTHEW F KLEMKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
304 NORTH 179TH STREET, SUITE 203, OMAHA, NE 68118-3569
(402) 614-4322
(402) 614-4475
Mailing address
304 N. 179TH STREET, SUITE 203, OMAHA, NE 68118-3569
(402) 614-4322
(402) 614-4475
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1178
NE
152WC0802X
Corneal and Contact Management Optometrist
1178
NE
152WP0200X
Pediatric Optometrist
1178
NE
152WS0006X
Sports Vision Optometrist
1178
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37054
BCBS
NE
01
—
P00219077
RAILROAD MEDICARE DD2869
NE
Enumeration date
07/21/2006
Last updated
01/02/2020
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