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NPI Code Detail

MEDICARE: GREGG FOOTE M.D.

MEDICARE: GREGG FOOTE M.D.
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
12085R0202XDiagnostic Radiology Physician14445NE

General Provider Information

NPI Number : 1801855002
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGG FOOTE M.D.
Provider Business Mailing Address
First Line : PO BOX 609
Second Line :
City : SHELTON
State : NE
Zip : 68876-0609
Country : US
Telephone Number : 308-647-4900
Fax Number : 308-647-5378
Provider Business Practice Location Address
First Line : 4600 38TH ST
Second Line :
City : COLUMBUS
State : NE
Zip : 68601-1664
Country : US
Telephone Number : 308-647-4900
Fax Number : 308-647-5378
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 09/29/2010

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