Healthcare Provider Details

I. General information

NPI: 1225213283
Provider Name (Legal Business Name): BRITT A THEDINGER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 01/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8005 FARNAM DR STE 206
OMAHA NE
68114-3426
US

IV. Provider business mailing address

8005 FARNAM DR STE 206
OMAHA NE
68114-3426
US

V. Phone/Fax

Practice location:
  • Phone: 402-933-3277
  • Fax: 402-933-2216
Mailing address:
  • Phone: 402-933-3277
  • Fax: 402-933-2216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number18188
License Number StateNE

VIII. Authorized Official

Name: DR. BRITT ASHLEY THEDINGER
Title or Position: CEO
Credential: MD
Phone: 402-933-3277