Healthcare Provider Details

I. General information

NPI: 1730320722
Provider Name (Legal Business Name): NOBLE SPINE CENTRE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2009
Last Update Date: 01/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4220 PIONEER WOODS DR STE B
LINCOLN NE
68506-7564
US

IV. Provider business mailing address

PO BOX 80408
LINCOLN NE
68501-0408
US

V. Phone/Fax

Practice location:
  • Phone: 402-484-4845
  • Fax:
Mailing address:
  • Phone: 405-947-5557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number1927
License Number StateNE

VIII. Authorized Official

Name: DR. DANIEL P NOBLE
Title or Position: OWNER
Credential: MD
Phone: 402-484-4845