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NPI Code Detail

MEDICARE: DR. TIMOTHY PATRICK O'HOLLERAN M.D.

MEDICARE: DR. TIMOTHY PATRICK O'HOLLERAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician15145NE

General Provider Information

NPI Number : 1154360188
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY PATRICK O'HOLLERAN M.D.
Provider Business Mailing Address
First Line : 1001 DEERWOOD DR
Second Line :
City : NORTH PLATTE
State : NE
Zip : 69101-6317
Country : US
Telephone Number : 308-532-8783
Fax Number : 308-534-3813
Provider Business Practice Location Address
First Line : 516 W LEOTA ST
Second Line :
City : NORTH PLATTE
State : NE
Zip : 69101-6533
Country : US
Telephone Number : 308-534-5370
Fax Number : 308-534-3813
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2006
Last Update Date : 07/14/2010

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