Provider Demographics
NPI:1902802994
Name:KLEIN, JEFFREY SCOTT (OD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:SCOTT
Last Name:KLEIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 W NORFOLK AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-4415
Mailing Address - Country:US
Mailing Address - Phone:402-371-8535
Mailing Address - Fax:402-371-7881
Practice Address - Street 1:2900 W NORFOLK AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-4415
Practice Address - Country:US
Practice Address - Phone:402-371-8535
Practice Address - Fax:402-371-7881
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1137152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE2200221OtherUNITED HEALTHCARE
NE36317OtherBLUE CROSS BLUE SHIELD
NE310OtherSTATE THERAPEUTIC LICENSE
NE47053709202Medicaid
NE1137OtherSTATE LICENSE
NE310OtherSTATE THERAPEUTIC LICENSE
NE47053709202Medicaid