Healthcare Provider Details

I. General information

NPI: 1457322281
Provider Name (Legal Business Name): DAVID D HULT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 10/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3910 VILLAGE DR
LINCOLN NE
68516-4783
US

IV. Provider business mailing address

2000 Q STREET SUITE 500
LINCOLN NE
68503-3610
US

V. Phone/Fax

Practice location:
  • Phone: 402-434-7383
  • Fax: 402-434-7382
Mailing address:
  • Phone: 402-421-0904
  • Fax: 402-421-0946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number16997
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: