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General NPI Number Information
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NPI Number | 1891875175
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Entity Type | Organization
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Legal Business Name | HEAD AND NECK SURGICAL PARTNERS LLC
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 10/24/2017
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Provider Practice Location Address
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Address Line | 1500 S 48TH ST STE 201
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City | LINCOLN
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State | NE
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Zip | 68506-1277
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Country | US
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Telephone | 402-488-5812
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Fax | 402-488-1356
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Provider Business Mailing Address
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Address Line | 1500 S 48TH ST STE 201
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City | LINCOLN
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State | NE
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Zip | 68506-1277
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Country | US
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Telephone | 402-488-5812
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Fax | 402-488-1356
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Authorized Official
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Title or Position | BOARD OF MANAGERS
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Name | DANA P WOLFE
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Credential | MD
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Telephone | 402-484-4974
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | ASC022
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License Number State | NE
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