Basic Information
| Provider Information | |||||||||
| NPI: | 1750443503 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHILDREN'S PHYSICIANS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8401 W DODGE RD | ||||||||
| Address2: | SUITE 280 | ||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681143451 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4029556877 | ||||||||
| FaxNumber: | 4029556880 | ||||||||
| Practice Location | |||||||||
| Address1: | 8401 W DODGE RD | ||||||||
| Address2: | SUITE 280 | ||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681143451 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4029556877 | ||||||||
| FaxNumber: | 4029556880 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/15/2006 | ||||||||
| LastUpdateDate: | 06/29/2012 | ||||||||
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| AuthorizedOfficialLastName: | STEVENSON | ||||||||
| AuthorizedOfficialFirstName: | SHIELA | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATIVE ASSISTANT | ||||||||
| AuthorizedOfficialTelephone: | 4029556810 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | NE | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.