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NPI 1407856453

NPI 1407856453 : THOMAS F WERNER MD : GRAND ISLAND, NE

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General NPI Number Information
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    NPI Number           |    1407856453
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    Entity Type          |    Individual 
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    Provider Name        |    THOMAS F WERNER MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/29/2005
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    Last Update Date     |    10/09/2023
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Provider Practice Location Address
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    Address Line         |    810 N DIERS AVE 
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    City                 |    GRAND ISLAND
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    State                |    NE
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    Zip                  |    68803-4955
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    Country              |    US
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    Telephone            |    308-381-2224
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    Fax                  |    308-398-1477
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Provider Business Mailing Address
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    Address Line         |    2729 LAKEWOOD DR 
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    City                 |    GRAND ISLAND
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    State                |    NE
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    Zip                  |    68801-7271
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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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        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    18270
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    License Number State |    NE
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