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General NPI Number Information
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NPI Number | 1366475758
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Entity Type | Organization
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Legal Business Name | NEBRASKA INTENSITY MODULATED RADIOTHERAPY PC
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 06/16/2017
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Provider Practice Location Address
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Address Line | 8001 EIGER DR
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City | LINCOLN
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State | NE
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Zip | 68516-6537
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Country | US
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Telephone | 402-904-7135
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Fax | 402-904-7175
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Provider Business Mailing Address
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Address Line | PO BOX 6951
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City | LINCOLN
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State | NE
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Zip | 68506-0951
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Country | US
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Telephone | 402-904-7135
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Fax | 402-904-7175
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BENNETT R BARRIOS
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Credential | MD
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Telephone | 402-904-7135
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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