MEDICARE: DR. ROBERT A COLLIGAN DPM

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	213E00000X	Podiatrist	262	NE

General Provider Information

NPI Number	:	1639198948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT A COLLIGAN DPM

Provider Business Mailing Address
First Line	:	1414 N. 13TH. ST.
Second Line	:
City	:	NORFOLK
State	:	NE
Zip	:	68702-0209
Country	:	US
Telephone Number	:	402-371-4690
Fax Number	:

Provider Business Practice Location Address
First Line	:	1410 N. 13TH. ST.
Second Line	:
City	:	NORFOLK
State	:	NE
Zip	:	68702-0209
Country	:	US
Telephone Number	:	402-371-4690
Fax Number	:

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

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	09/21/2009

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Directions to “ DR. ROBERT A COLLIGAN DPM” Practice Location

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