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NPI Code Detail

MEDICARE: MD WEST ONE, PC

MEDICARE: MD WEST ONE, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician
2363A00000XPhysician Assistant
3363L00000XNurse Practitioner
4207T00000XNeurological Surgery Physician

General Provider Information

NPI Number : 1164690574
Entity Type Code : Organization
Provider Name (Legal Business Name) : MD WEST ONE, PC
Provider Business Mailing Address
First Line : PO BOX 241353
Second Line :
City : OMAHA
State : NE
Zip : 68124-5353
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 808 E PIERCE ST
Second Line :
City : COUNCIL BLUFFS
State : IA
Zip : 51503-4601
Country : US
Telephone Number : 712-396-4061
Fax Number :
Authorized Official
Title or Position : OPERATIONS MANAGER
Name : LORI HILL
Credential :
Telephone Number : 402-398-9243
Provider Enumeration Date : 02/19/2008
Last Update Date : 12/17/2020

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Directions to “MD WEST ONE, PC ” Practice Location

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