Healthcare Provider Details

I. General information

NPI: 1396813200
Provider Name (Legal Business Name): ROGER C. MC CARTNEY, O.D.,AND BRANDON A. BLAIR, O.D.,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 11/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 N. 8TH ST.
LOUP CITY NE
68853-8065
US

IV. Provider business mailing address

132 N. 8TH ST.
LOUP CITY NE
68853-8065
US

V. Phone/Fax

Practice location:
  • Phone: 308-745-0803
  • Fax: 308-745-0803
Mailing address:
  • Phone: 308-745-0803
  • Fax: 308-745-0803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. ROGER C MCCARTNEY
Title or Position: CEO
Credential: O.D.
Phone: 308-745-0803