Healthcare Provider Details

I. General information

NPI: 1730181751
Provider Name (Legal Business Name): CAPITAL FOOT & ANKLE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 07/05/2017
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

Practice location:
  • Phone: 402-483-4485
  • Fax: 402-483-5372
Mailing address:
  • Phone: 402-483-4485
  • Fax: 402-483-5372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: JOHN J TENNITY
Title or Position: PHYSICIAN
Credential: D.P.M.
Phone: 402-483-4485