Healthcare Provider Details

I. General information

NPI: 1205915071
Provider Name (Legal Business Name): NEBRASKA HEMATOLOGY-ONCOLOGY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 05/01/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4004 PIONEER WOODS DR
LINCOLN NE
68506-7548
US

IV. Provider business mailing address

4004 PIONEER WOODS DR
LINCOLN NE
68506-7548
US

V. Phone/Fax

Practice location:
  • Phone: 402-484-4900
  • Fax: 402-484-6456
Mailing address:
  • Phone: 402-484-4900
  • Fax: 402-484-6456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: ERIC AVERY
Title or Position: PRESIDENT
Credential:
Phone: 402-484-4900