MEDICARE: JOE D METCALF II M.D.

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
1	207R00000X	Internal Medicine Physician	20110	NE
2	207P00000X	Emergency Medicine Physician	20110	NE

General Provider Information

NPI Number	:	1275512311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOE D METCALF II M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1800
Second Line	:
City	:	COLUMBUS
State	:	NE
Zip	:	68602-1800
Country	:	US
Telephone Number	:	402-564-7118
Fax Number	:	402-562-3378

Provider Business Practice Location Address
First Line	:	4600 38TH ST
Second Line	:
City	:	COLUMBUS
State	:	NE
Zip	:	68601
Country	:	US
Telephone Number	:	402-564-7118
Fax Number	:	402-562-3378

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2006
Last Update Date	:	05/17/2018

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