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General NPI Number Information
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NPI Number | 1609855568
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Entity Type | Organization
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Legal Business Name | BELLEVUE FOOT CENTER, P.C.
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Dates
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Enumeration Date | 01/10/2006
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Last Update Date | 02/02/2023
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Provider Practice Location Address
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Address Line | 1413 S WASHINGTON ST STE 270
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City | PAPILLION
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State | NE
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Zip | 68046-4193
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Country | US
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Telephone | 402-291-3123
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Fax | 402-291-1560
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Provider Business Mailing Address
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Address Line | 1413 S WASHINGTON ST STE 270
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City | PAPILLION
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State | NE
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Zip | 68046-4193
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Country | US
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Telephone | 402-291-3123
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Fax |
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Authorized Official
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Title or Position | OWNER/PODIATRIST
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Name | JONATHAN MICHAEL LITTLE
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Credential | DPM
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Telephone | 402-291-3123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 186
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License Number State | NE
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