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General NPI Number Information
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NPI Number | 1073559183
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Entity Type | Individual
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Provider Name | PATRICK D MAHONEY MD
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Gender | Male
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 16901 LAKESIDE HILLS CT ALEGENT LAKESIDE HOSPITAL DEPT OF RADIOLOGY
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City | OMAHA
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State | NE
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Zip | 68130-2318
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Country | US
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Telephone | 404-717-8146
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4460
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City | OMAHA
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State | NE
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Zip | 68104
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Country | US
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Telephone | 866-491-5807
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Fax | 913-491-0411
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 12298
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 18707
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License Number State | IA
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