Healthcare Provider Details

I. General information

NPI: 1821014424
Provider Name (Legal Business Name): DORSEY EYECARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 03/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 S 14TH ST STE 202
ORD NE
68862-1755
US

IV. Provider business mailing address

PO BOX 100
ORD NE
68862-0100
US

V. Phone/Fax

Practice location:
  • Phone: 308-728-7700
  • Fax: 308-728-7720
Mailing address:
  • Phone: 308-728-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. MINDY K DORSEY
Title or Position: PRESIDENT
Credential: O.D.
Phone: 308-728-7700