Basic Information
| Provider Information | |||||||||
| NPI: | 1972553584 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BABBITT | ||||||||
| FirstName: | TIMOTHY | ||||||||
| MiddleName: | DANIEL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2700 W NORFOLK AVE | ||||||||
| Address2: | |||||||||
| City: | NORFOLK | ||||||||
| State: | NE | ||||||||
| PostalCode: | 687014438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4026447543 | ||||||||
| FaxNumber: | 4026447503 | ||||||||
| Practice Location | |||||||||
| Address1: | 2700 W NORFOLK AVE | ||||||||
| Address2: | |||||||||
| City: | NORFOLK | ||||||||
| State: | NE | ||||||||
| PostalCode: | 687014438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4026447543 | ||||||||
| FaxNumber: | 4026447503 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2006 | ||||||||
| LastUpdateDate: | 03/14/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 23039 | NE | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | P00177175 | 01 | RAILROAD MEDICARE | OTHER | 39-02020 | 01 | NE | SHAREADVANTAGE | OTHER | 0588939 | 05 | IA | MEDICAID | 39-02021 | 01 | NE | SHAREADVANTAGE MEDICAID | OTHER | 06208 | 01 | BCBS | OTHER | 245258 | 01 | NE | MLDCH AND MUTLOF OMAHA | OTHER | 100251217-00 | 05 | NE | MEDICAID | 2588939 | 05 | IA | MEDICAID | P00177175 | 01 | NE | RAILROAD MEDICARE | OTHER | 100249951-00 | 05 | NE | MEDICAID |