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General NPI Number Information
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NPI Number | 1386693455
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Entity Type | Individual
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Provider Name | PATRICK BOGARD MD
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Gender | Male
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 06/08/2010
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Provider Practice Location Address
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Address Line | 4955 F STREET
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City | OMAHA
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State | NE
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Zip | 68117
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Country | US
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Telephone | 402-717-2871
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Fax | 402-717-5231
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Provider Business Mailing Address
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Address Line | PO BOX 4907
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City | OMAHA
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State | NE
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Zip | 68104
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Country | US
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Telephone | 800-831-2402
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Fax | 770-666-9514
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZC0500X
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Taxonomy Name | Cytopathology Physician
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License Number | 15641
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 207ZC0500X
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Taxonomy Name | Cytopathology Physician
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License Number | 22053
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 15641
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License Number State | NE
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Taxonomy #4
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 22053
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License Number State | IA
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