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NPI Code Detail

MEDICARE: MR. JOHN J. TENNITY D.P.M.

MEDICARE:  MR. JOHN J. TENNITY  D.P.M.
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
1213ES0103XFoot & Ankle Surgery Podiatrist237NE

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
248033679OTHERNERAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
32572OTHERNEBLUE CROSS BLUE SHIELD ID
427-00182OTHERNEUNITED HEALTHCARE ID

General Provider Information

NPI Number : 1194728915
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN J. TENNITY D.P.M.
Provider Business Mailing Address
First Line : 1150 N 83RD ST
Second Line :
City : LINCOLN
State : NE
Zip : 68505-2094
Country : US
Telephone Number : 402-483-4485
Fax Number : 402-483-5372
Provider Business Practice Location Address
First Line : 1150 N 83RD ST
Second Line :
City : LINCOLN
State : NE
Zip : 68505-2094
Country : US
Telephone Number : 402-483-4485
Fax Number : 402-483-5372
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 01/30/2012

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Directions to “ MR. JOHN J. TENNITY D.P.M.” Practice Location

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