Healthcare Provider Details

I. General information

NPI: 1710368527
Provider Name (Legal Business Name): PAUL JOSEPH AYLWARD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2015
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

987400 NEBRASKA MEDICAL CTR
OMAHA NE
68198-7400
US

IV. Provider business mailing address

12310 WOOLWORTH AVE
OMAHA NE
68144-1453
US

V. Phone/Fax

Practice location:
  • Phone: 402-552-2000
  • Fax:
Mailing address:
  • Phone: 402-617-8687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number04-51739
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number04-51739
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number04-51739
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: