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NPI Code Detail

MEDICARE: NEBRASKA TRAUMA AND ACUTE CARE SURGERY PC

MEDICARE: NEBRASKA TRAUMA AND ACUTE CARE SURGERY PC
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
12086S0127XTrauma Surgery Physician
22086S0102XSurgical Critical Care Physician
3208600000XSurgery Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316981152
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEBRASKA TRAUMA AND ACUTE CARE SURGERY PC
Provider Business Mailing Address
First Line : PO BOX 67250
Second Line :
City : LINCOLN
State : NE
Zip : 68506-7250
Country : US
Telephone Number : 402-328-8833
Fax Number : 402-875-5868
Provider Business Practice Location Address
First Line : 2300 S 16TH ST
Second Line :
City : LINCOLN
State : NE
Zip : 68502-3704
Country : US
Telephone Number : 402-481-5194
Fax Number : 402-481-5377
Authorized Official
Title or Position : OWNER
Name : DR. REGINALD A BURTON
Credential : M.D.
Telephone Number : 402-481-5194
Provider Enumeration Date : 06/15/2006
Last Update Date : 06/29/2012

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