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General NPI Number Information
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NPI Number | 1861455859
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Entity Type | Organization
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Legal Business Name | JOHN R. KIRCHNER, MD
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 13906 GOLD CIR SUITE 101
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City | OMAHA
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State | NE
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Zip | 68144-2336
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Country | US
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Telephone | 402-759-2910
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Fax | 402-758-2956
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Provider Business Mailing Address
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Address Line | 13906 GOLD CIR SUITE 101
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City | OMAHA
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State | NE
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Zip | 68144-2336
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Country | US
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Telephone | 402-758-2910
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Fax | 402-758-2956
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Authorized Official
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Title or Position | MD
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Name | DR. JOHN R KIRCHNER
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Credential | MD
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Telephone | 402-758-2910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 10745
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License Number State | NE
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