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General NPI Number Information
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NPI Number | 1770801789
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Entity Type | Organization
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Legal Business Name | MARY JO HANIGAN M.D., P.C.
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Dates
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Enumeration Date | 05/14/2010
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 6910 PACIFIC ST STE 100
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City | OMAHA
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State | NE
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Zip | 68106-1044
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Country | US
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Telephone | 402-504-3707
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Fax | 402-504-3714
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Provider Business Mailing Address
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Address Line | 6910 PACIFIC ST STE 100
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City | OMAHA
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State | NE
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Zip | 68106-1044
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Country | US
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Telephone | 402-504-3707
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Fax |
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Authorized Official
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Title or Position | M.D.
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Name | MARY JO HANIGAN
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Credential | M.D.
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Telephone | 402-504-3707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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