Healthcare Provider Details

I. General information

NPI: 1316235179
Provider Name (Legal Business Name): CHILDREN FIRST PEDIATRICS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2011
Last Update Date: 07/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4230 PIONEER WOODS DR SUITE B
LINCOLN NE
68506-7565
US

IV. Provider business mailing address

4230 PIONEER WOODS DR SUITE B
LINCOLN NE
68506-7565
US

V. Phone/Fax

Practice location:
  • Phone: 402-488-7337
  • Fax:
Mailing address:
  • Phone: 402-488-7337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberNE18979
License Number StateNE

VIII. Authorized Official

Name: DR. ROBERT K. KOCH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 402-488-7337