Unknown Individual – Family Medicine Physician, NPI 1205940319
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
14475, Tibbles Street, Omaha, Douglas County, Nebraska, 68116, United States
OMAHA, NE 681166637
Phone: (402) 294-6033
Fax: (402) 294-9399
Type: Mailing
2501 CAPEHART RD
OFFUTT A F B, NE 681131043
Phone: (402) 294-6033
Fax: (402) 294-9399
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 68116)
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