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General NPI Number Information
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NPI Number | 1093979163
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Entity Type | Organization
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Legal Business Name | POPP COSMETIC SURGERY PC
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Dates
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Enumeration Date | 07/17/2008
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Last Update Date | 07/17/2008
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Provider Practice Location Address
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Address Line | 11919 GRANT ST SUITE 100
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City | OMAHA
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State | NE
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Zip | 68164-3475
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Country | US
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Telephone | 402-391-4558
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Fax | 402-391-7401
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Provider Business Mailing Address
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Address Line | 11919 GRANT ST SUITE 100
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City | OMAHA
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State | NE
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Zip | 68164-3475
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Country | US
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Telephone | 402-391-4558
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Fax | 402-391-7401
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. JEFFREY COLLINS POPP
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Credential | MD
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Telephone | 402-391-4558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 15046
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License Number State | NE
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