Healthcare Provider Details

I. General information

NPI: 1003886813
Provider Name (Legal Business Name): LINDA B FORD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3503 SAMSON WAY SUITE 108
BELLEVUE NE
68123-4303
US

IV. Provider business mailing address

3503 SAMSON WAY SUITE 108
BELLEVUE NE
68123-4303
US

V. Phone/Fax

Practice location:
  • Phone: 402-592-2055
  • Fax: 402-592-2419
Mailing address:
  • Phone: 402-592-2055
  • Fax: 402-592-2419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number14379
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: