Healthcare Provider Details

I. General information

NPI: 1447343405
Provider Name (Legal Business Name): THOMAS JAMES DOBLEMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 06/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11704 W CENTER RD SUITE 211
OMAHA NE
68144-4375
US

IV. Provider business mailing address

11704 W CENTER RD SUITE 211
OMAHA NE
68144-4375
US

V. Phone/Fax

Practice location:
  • Phone: 402-393-7050
  • Fax: 402-393-2814
Mailing address:
  • Phone: 402-393-7050
  • Fax: 402-393-2814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number18235
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number18235
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number18235
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: