Basic Information
| Provider Information | |||||||||
| NPI: | 1437105160 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WESTROADS MEDICAL GROUP, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10170 NICHOLAS ST | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681142174 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4023913800 | ||||||||
| FaxNumber: | 4029341676 | ||||||||
| Practice Location | |||||||||
| Address1: | 10170 NICHOLAS ST | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681142174 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4023913800 | ||||||||
| FaxNumber: | 4029341676 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | MORRIS | ||||||||
| AuthorizedOfficialFirstName: | CHRIS | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 4023913800 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | X | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 207RR0500X | X | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
No ID Information.