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General NPI Number Information
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NPI Number | 1679524755
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Entity Type | Individual
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Provider Name | JOSHUA WADE ENGEL O.D.
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Gender | Male
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Dates
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Enumeration Date | 05/13/2006
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Last Update Date | 06/27/2017
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Provider Practice Location Address
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Address Line | 3400 N 27TH ST
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City | LINCOLN
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State | NE
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Zip | 68521-1314
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Country | US
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Telephone | 402-465-5577
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Fax | 402-465-0312
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Provider Business Mailing Address
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Address Line | 1171 N COTNER BLVD
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City | LINCOLN
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State | NE
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Zip | 68505-1835
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Country | US
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Telephone | 402-465-5577
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Fax | 402-465-0312
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1182
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License Number State | NE
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