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General NPI Number Information
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NPI Number | 1346597820
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Entity Type | Organization
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Legal Business Name | THOMAS N. FENNESSY M.D., P.C.
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Dates
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Enumeration Date | 08/14/2012
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Last Update Date | 09/11/2012
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Provider Practice Location Address
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Address Line | 109 N 29TH ST
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City | NORFOLK
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State | NE
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Zip | 68701-3251
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Country | US
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Telephone | 402-316-4320
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Fax | 402-316-4330
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Provider Business Mailing Address
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Address Line | 109 N 29TH ST
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City | NORFOLK
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State | NE
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Zip | 68701-3251
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Country | US
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Telephone | 402-316-4320
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Fax | 402-316-4330
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Authorized Official
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Title or Position | PHYSICIAN / PRESIDENT
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Name | DR. THOMAS N. FENNESSY
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Credential | M.D.
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Telephone | 402-316-4320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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