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General NPI Number Information
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NPI Number | 1922020999
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Entity Type | Organization
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Legal Business Name | HEARTLAND VEIN AND VASCULAR INSTITUTE, P.C.
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 07/28/2014
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Provider Practice Location Address
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Address Line | 12702 WESTPORT PKWY #101
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City | OMAHA
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State | NE
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Zip | 68138-4012
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Country | US
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Telephone | 402-614-0026
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Fax | 402-614-1877
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Provider Business Mailing Address
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Address Line | 12702 WESTPORT PKWY #101
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City | OMAHA
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State | NE
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Zip | 68138-4012
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Country | US
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Telephone | 402-614-0026
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Fax | 402-614-1877
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Authorized Official
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Title or Position | M.D./PRESIDENT
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Name | THOMAS B WHITTLE
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Credential | M.D.
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Telephone | 402-614-0026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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