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General NPI Number Information
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NPI Number | 1316133804
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Entity Type | Organization
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Legal Business Name | EAR, NOSE & THROAT MEDICINE & SURGERY P.C.
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 09/19/2007
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Provider Practice Location Address
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Address Line | 630 N COTNER BLVD STE. 202
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City | LINCOLN
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State | NE
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Zip | 68505-2339
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Country | US
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Telephone | 402-464-8385
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Fax |
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Provider Business Mailing Address
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Address Line | 630 N COTNER BLVD STE. 202
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City | LINCOLN
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State | NE
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Zip | 68505-2339
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Country | US
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Telephone | 402-464-8385
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHARLES BARTON
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Credential | M.D.
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Telephone | 402-464-8385
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0602X
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Taxonomy Name | Otolaryngic Allergy Physician
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License Number | 12569
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License Number State | NE
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