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NPI Code Detail

MEDICARE: CRAIG E RILEY DPM PC

MEDICARE: CRAIG E RILEY DPM 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
1213E00000XPodiatrist139NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12537OTHERBLUE CROSS

General Provider Information

NPI Number : 1437148525
Entity Type Code : Organization
Provider Name (Legal Business Name) : CRAIG E RILEY DPM PC
Provider Business Mailing Address
First Line : 2724 13TH ST
Second Line :
City : COLUMBUS
State : NE
Zip : 68601-4917
Country : US
Telephone Number : 402-563-3668
Fax Number : 402-563-3669
Provider Business Practice Location Address
First Line : 2724 13TH ST
Second Line :
City : COLUMBUS
State : NE
Zip : 68601-4917
Country : US
Telephone Number : 402-563-3668
Fax Number : 402-563-3669
Authorized Official
Title or Position : PRESIDENT
Name : DR. CRAIG E RILEY
Credential : DPM
Telephone Number : 402-563-3668
Provider Enumeration Date : 10/20/2005
Last Update Date : 04/20/2008

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