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General NPI Number Information
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NPI Number | 1003004813
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Entity Type | Organization
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Legal Business Name | PROEYE GROUP GATEWAY, P.C.
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Dates
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Enumeration Date | 10/05/2007
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Last Update Date | 01/12/2021
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Provider Practice Location Address
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Address Line | 8250 OLD CHENEY RD STE A
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City | LINCOLN
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State | NE
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Zip | 68516-3533
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Country | US
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Telephone | 402-817-5626
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Fax | 402-817-5631
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Provider Business Mailing Address
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Address Line | 8250 OLD CHENEY RD STE A
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City | LINCOLN
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State | NE
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Zip | 68516-3533
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Country | US
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Telephone | 402-817-5626
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Fax | 402-817-5631
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. WILLIAM JEFFREY GEISERT
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Credential | O.D.
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Telephone | 402-730-4842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 944
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License Number State | NE
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