Healthcare Provider Details

I. General information

NPI: 1407174584
Provider Name (Legal Business Name): DANIEL EDWARD HATZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2010
Last Update Date: 10/21/2021
Certification Date: 10/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 CAPEHART RD
OFFUTT AFB NE
68113-1043
US

IV. Provider business mailing address

2501 CAPEHART RD
BELLEVUE NE
68123-0000
US

V. Phone/Fax

Practice location:
  • Phone: 402-740-7710
  • Fax:
Mailing address:
  • Phone: 402-740-7710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0000000000000
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number32870
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: