Healthcare Provider Details

I. General information

NPI: 1316981152
Provider Name (Legal Business Name): NEBRASKA TRAUMA AND ACUTE CARE SURGERY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 06/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 S 16TH ST
LINCOLN NE
68502-3704
US

IV. Provider business mailing address

PO BOX 67250
LINCOLN NE
68506-7250
US

V. Phone/Fax

Practice location:
  • Phone: 402-481-5194
  • Fax: 402-481-5377
Mailing address:
  • Phone: 402-328-8833
  • Fax: 402-875-5868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. REGINALD A BURTON
Title or Position: OWNER
Credential: M.D.
Phone: 402-481-5194