Healthcare Provider Details

I. General information

NPI: 1932898293
Provider Name (Legal Business Name): JOHN P BADER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2023
Last Update Date: 05/03/2023
Certification Date: 05/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 SO. 70TH STREET STE. 200
LINCOLN NE
68510-4293
US

IV. Provider business mailing address

1101 SO. 70TH STREET STE. 200
LINCOLN NE
68510-4293
US

V. Phone/Fax

Practice location:
  • Phone: 402-486-3132
  • Fax: 402-486-3187
Mailing address:
  • Phone: 402-486-3132
  • Fax: 402-486-3187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DRU E BECKER
Title or Position: OFFICE MANAGER
Credential:
Phone: 402-486-3132