Healthcare Provider Details

I. General information

NPI: 1881659787
Provider Name (Legal Business Name): CURTIS LEE BOECK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 01/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N 30TH ST SUITE 3222
OMAHA NE
68131-2128
US

IV. Provider business mailing address

7261 MERCY RD
OMAHA NE
68124-2311
US

V. Phone/Fax

Practice location:
  • Phone: 402-449-4847
  • Fax: 402-449-4885
Mailing address:
  • Phone: 402-449-4847
  • Fax: 402-449-4885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number32453
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number208038
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: