Healthcare Provider Details

I. General information

NPI: 1811098841
Provider Name (Legal Business Name): LINCOLN OB-GYN P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 04/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9110 ANDERMATT DRIVE SUITE 2
LINCOLN NE
68526-9639
US

IV. Provider business mailing address

9110 ANDERMATT DR STE 2
LINCOLN NE
68526-6701
US

V. Phone/Fax

Practice location:
  • Phone: 402-483-7641
  • Fax: 402-483-0527
Mailing address:
  • Phone: 402-483-7641
  • Fax: 402-483-0527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. YVONNE K DAVENPORT
Title or Position: CORPORATE SECRETARY
Credential: MD
Phone: 402-483-7641