Basic Information
| Provider Information | |||||||||
| NPI: | 1184379836 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | NEBRASKA ORTHOPAEDIC CENTER PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6900 A ST STE 100 | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685104120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024362000 | ||||||||
| FaxNumber: | 4024342691 | ||||||||
| Practice Location | |||||||||
| Address1: | 575 S 70TH ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685102471 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024883322 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2022 | ||||||||
| LastUpdateDate: | 02/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | TEWES | ||||||||
| AuthorizedOfficialFirstName: | DOUGLAS | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4024362000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | NEBRASKA ORTHOPAEDIC CENTER PC | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | 02/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.