Healthcare Provider Details
I. General information
NPI: 1235461294
Provider Name (Legal Business Name): JOSHUA MORTON VEST D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/02/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1150 N 83RD ST
LINCOLN NE
68505-2094
US
IV. Provider business mailing address
1150 N 83RD ST
LINCOLN NE
68505-2094
US
V. Phone/Fax
- Phone: 402-483-4485
- Fax:
- Phone: 402-483-4485
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | 5901002288 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | 12-00433 |
| License Number State | KS |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | 326 |
| License Number State | NE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: