Provider Demographics
NPI:1942538921
Name:BYFORD J KLEIN OD PC
Entity type:Organization
Organization Name:BYFORD J KLEIN OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:BYFORD
Authorized Official - Middle Name:J
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD PC
Authorized Official - Phone:402-426-4601
Mailing Address - Street 1:257 S 19TH ST
Mailing Address - Street 2:
Mailing Address - City:BLAIR
Mailing Address - State:NE
Mailing Address - Zip Code:68008-1903
Mailing Address - Country:US
Mailing Address - Phone:402-426-4601
Mailing Address - Fax:402-426-4710
Practice Address - Street 1:257 S 19TH ST
Practice Address - Street 2:
Practice Address - City:BLAIR
Practice Address - State:NE
Practice Address - Zip Code:68008-1903
Practice Address - Country:US
Practice Address - Phone:402-426-4601
Practice Address - Fax:402-426-4710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-02
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE6774OtherBCBS OF NEBRASKA
NE6774OtherBCBS OF NEBRASKA
NE0322740001Medicare NSC
NET93175Medicare UPIN