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General NPI Number Information
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NPI Number | 1215284468
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Entity Type | Organization
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Legal Business Name | FOOT AND ANKLE DOCTORS PC
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Dates
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Enumeration Date | 08/07/2012
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Last Update Date | 08/17/2012
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Provider Practice Location Address
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Address Line | 110 N 37TH ST 101
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City | NORFOLK
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State | NE
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Zip | 68701-3283
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Country | US
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Telephone | 402-371-4690
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Fax | 402-379-8061
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Provider Business Mailing Address
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Address Line | 110 N 37TH ST 101
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City | NORFOLK
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State | NE
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Zip | 68701-3283
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Country | US
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Telephone | 402-371-4690
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Fax | 402-379-8061
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Authorized Official
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Title or Position | CEO
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Name | DR. ROBERT A COLLIGAN
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Credential | DPM
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Telephone | 402-371-4690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 262
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License Number State | NE
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