Healthcare Provider Details

I. General information

NPI: 1316994825
Provider Name (Legal Business Name): NEBRASKA ORTHOPAEDIC ASSOCIATES LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 05/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2725 S 144TH ST #110
OMAHA NE
68144-5243
US

IV. Provider business mailing address

2725 S 144TH ST #110
OMAHA NE
68144-5243
US

V. Phone/Fax

Practice location:
  • Phone: 402-637-0400
  • Fax: 402-637-0401
Mailing address:
  • Phone: 402-637-0400
  • Fax: 402-637-0401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: STEVEN X GOEBEL
Title or Position: COMPLIANCE COORDINATOR
Credential: M.D.
Phone: 402-637-0400