MEDICARE: THE PHYSICIAN NETWORK

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy
1	207LC0200X	Critical Care Medicine (Anesthesiology) Physician
2	207P00000X	Emergency Medicine Physician
3	207R00000X	Internal Medicine Physician
4	207RN0300X	Nephrology Physician
5	207V00000X	Obstetrics & Gynecology Physician
6	207Y00000X	Otolaryngology Physician
7	208100000X	Physical Medicine & Rehabilitation Physician
8	2084P0800X	Psychiatry Physician
9	208600000X	Surgery Physician
10	208M00000X	Hospitalist Physician
11	235500000X	Speech/Language/Hearing Specialist/Technologist
12	363AM0700X	Medical Physician Assistant
13	363L00000X	Nurse Practitioner
14	207Q00000X	Family Medicine Physician

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

NPI Number	:	1437184652
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE PHYSICIAN NETWORK

Provider Business Mailing Address
First Line	:	2000 Q ST
Second Line	:	SUITE 500
City	:	LINCOLN
State	:	NE
Zip	:	68503-3609
Country	:	US
Telephone Number	:	402-421-0896
Fax Number	:	402-421-0945

Provider Business Practice Location Address
First Line	:	7440 S 91ST ST
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68526-9797
Country	:	US
Telephone Number	:	402-421-0896
Fax Number	:	402-421-0945

Authorized Official
Title or Position	:	SYSTEM SENIOR VP
Name	:	DAVID PRITZA
Credential	:
Telephone Number	:	402-343-4477

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	09/25/2023

7440 SOUTH 91ST STREET
LINCOLN, NE
68526-9797

Practice Phone: 402-489-6555
Practice Fax: 402-328-3989

7440 S 91ST ST
LINCOLN, NE
68526-9797