Healthcare Provider Details
I. General information
NPI: 1073686812
Provider Name (Legal Business Name): HEMATOLOGY & ONCOLOGY CONSULTANTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/17/2006
Last Update Date: 12/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6901 N 72ND ST SUITE 2244
OMAHA NE
68122-1709
US
IV. Provider business mailing address
PO BOX 641850
OMAHA NE
68164-7850
US
V. Phone/Fax
- Phone: 402-572-3535
- Fax: 402-572-2892
- Phone: 402-572-3535
- Fax: 402-572-2892
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 22157 |
| License Number State | NE |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 13385 |
| License Number State | NE |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 21140 |
| License Number State | NE |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 20876 |
| License Number State | NE |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | 17561 |
| License Number State | NE |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 1301 |
| License Number State | NE |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | 1294 |
| License Number State | NE |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 110233 |
| License Number State | NE |
| # 9 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 15291 |
| License Number State | NE |
VIII. Authorized Official
Name: MS.
CAROL
RENEE
MURTAUGH
Title or Position: PRACTICE ADMINISTRATOR
Credential: RN
Phone: 402-572-3535