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General NPI Number Information
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NPI Number | 1548287907
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Entity Type | Organization
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Legal Business Name | ALEGENT CREIGHTON CLINIC
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 09/18/2023
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Provider Practice Location Address
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Address Line | 7500 MERCY RD
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City | OMAHA
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State | NE
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Zip | 68124-2319
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Country | US
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Telephone | 402-717-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 7261 MERCY RD ATTN: CREDENTIALING
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City | OMAHA
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State | NE
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Zip | 68124-2311
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Country | US
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Telephone | 402-398-6255
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Fax |
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Authorized Official
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Title or Position | SYSTEM SVP
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Name | DAVID PRITZA
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Credential | MD
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Telephone | 402-343-4477
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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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