Provider Demographics
NPI:1053394791
Name:SLEPICKA, CRAIG ALAN (OD)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:ALAN
Last Name:SLEPICKA
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 1:334 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:SEWARD
Mailing Address - State:NE
Mailing Address - Zip Code:68434-2517
Mailing Address - Country:US
Mailing Address - Phone:402-643-2944
Mailing Address - Fax:402-643-2945
Practice Address - Street 1:334 S 4TH ST
Practice Address - Street 2:
Practice Address - City:SEWARD
Practice Address - State:NE
Practice Address - Zip Code:68434-2517
Practice Address - Country:US
Practice Address - Phone:402-643-2944
Practice Address - Fax:402-643-2945
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1050152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEU51144Medicare UPIN
NE268436SLMedicare ID - Type Unspecified