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NPI Code Detail

MEDICARE: CODY M. LAY O.D. P.C.

MEDICARE: CODY M. LAY O.D. P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist1205NE

General Provider Information

NPI Number : 1588962534
Entity Type Code : Organization
Provider Name (Legal Business Name) : CODY M. LAY O.D. P.C.
Provider Business Mailing Address
First Line : 6620 MEURSAULT DR
Second Line :
City : LINCOLN
State : NE
Zip : 68526-9591
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 818 E 23RD ST
Second Line :
City : COLUMBUS
State : NE
Zip : 68601-3866
Country : US
Telephone Number : 402-564-0474
Fax Number : 402-562-5488
Authorized Official
Title or Position : OPTOMETRIST
Name : DR. CODY MICHAEL LAY
Credential : O.D.
Telephone Number : 402-328-9849
Provider Enumeration Date : 02/28/2011
Last Update Date : 02/28/2011

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