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General NPI Number Information
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NPI Number | 1750538575
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Entity Type | Individual
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Provider Name | JEREMIAH FLEENOR MD
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Gender | Male
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Dates
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Enumeration Date | 08/22/2008
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Last Update Date | 07/29/2014
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Provider Practice Location Address
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Address Line | 2700 W NORFOLK AVE
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City | NORFOLK
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State | NE
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Zip | 68701-4438
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Country | US
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Telephone | 402-644-8121
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Fax |
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Provider Business Mailing Address
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Address Line | 2700 W NORFOLK AVE
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City | NORFOLK
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State | NE
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Zip | 68701-4438
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Country | US
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Telephone | 402-644-8121
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 125052263
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 48533
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 27327
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License Number State | NE
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