Healthcare Provider Details

I. General information

NPI: 1184189821
Provider Name (Legal Business Name): ERIC ANTHONY HEIDEMANN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2019
Last Update Date: 07/17/2025
Certification Date: 07/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 N KANSAS AVE STE 106
HASTINGS NE
68901-4422
US

IV. Provider business mailing address

2314 HUDSON WAY APT 105
HASTINGS NE
68901
US

V. Phone/Fax

Practice location:
  • Phone: 402-462-2139
  • Fax:
Mailing address:
  • Phone: 402-641-7720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberOS17355
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number3016
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: