Healthcare Provider Details

I. General information

NPI: 1023306792
Provider Name (Legal Business Name): KUGLER VISION PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2011
Last Update Date: 07/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13923 GOLD CIRCLE
OMAHA NE
68144-2379
US

IV. Provider business mailing address

13923 GOLD CIR
OMAHA NE
68144-2379
US

V. Phone/Fax

Practice location:
  • Phone: 402-558-2211
  • Fax: 402-558-3456
Mailing address:
  • Phone: 402-558-2211
  • Fax: 402-558-3456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number23266
License Number StateNE

VIII. Authorized Official

Name: LANCE J KUGLER
Title or Position: PRES/OWNER
Credential: MD
Phone: 402-558-2211