Healthcare Provider Details

I. General information

NPI: 1306929054
Provider Name (Legal Business Name): THOMAS J DEEGAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 DODGE ST CHILDREN'S HOSPITAL-EMERGENCY DEPARTMENT
OMAHA NE
68114-4113
US

IV. Provider business mailing address

8200 DODGE ST CHILDREN'S HOSPITAL-EMERGENCY DEPARTMENT
OMAHA NE
68114-4113
US

V. Phone/Fax

Practice location:
  • Phone: 402-955-5150
  • Fax: 402-955-5125
Mailing address:
  • Phone: 402-955-5150
  • Fax: 402-955-5125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301051110
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number4301051110
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number23799
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: