Healthcare Provider Details

I. General information

NPI: 1316983216
Provider Name (Legal Business Name): OMAHA OBGYN ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 11/16/2021
Certification Date: 11/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 N 51ST ST STE 200
OMAHA NE
68132-2867
US

IV. Provider business mailing address

119 N 51ST ST STE 200
OMAHA NE
68132-2867
US

V. Phone/Fax

Practice location:
  • Phone: 402-932-8020
  • Fax: 402-905-3040
Mailing address:
  • Phone: 402-932-8020
  • Fax: 402-905-3042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. FRANKLIN DANIEL DEVRIES
Title or Position: PRESIDENT
Credential: M.D.
Phone: 402-932-8020