Healthcare Provider Details

I. General information

NPI: 1073569125
Provider Name (Legal Business Name): MIDWEST GASTROINTESTINAL ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 04/03/2024
Certification Date: 04/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 INDIAN HILLS DR SUITE 200
OMAHA NE
68114-4057
US

IV. Provider business mailing address

8901 INDIAN HILLS DR SUITE 200
OMAHA NE
68114-4057
US

V. Phone/Fax

Practice location:
  • Phone: 402-397-7057
  • Fax: 402-397-6656
Mailing address:
  • Phone: 402-397-7057
  • Fax: 402-397-6656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM C LIVINGSTON
Title or Position: OWNER
Credential: DO
Phone: 402-397-7057