MEDICARE: BRIAN DUANE FOOTE MD

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
1	2085R0202X	Diagnostic Radiology Physician	15476	NE

Other Identifiers

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

General Provider Information

NPI Number	:	1629078696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN DUANE FOOTE MD

Provider Business Mailing Address
First Line	:	1801 SAINT ANDREWS PL
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68512-1822
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 O ST
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68508-1766
Country	:	US
Telephone Number	:	402-475-7000
Fax Number	:	402-475-6003

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	07/08/2007

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