Provider Demographics
NPI:1003949199
Name:WITTER FAMILY MEDICINE
Entity Type:Organization
Organization Name:WITTER FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JO
Authorized Official - Middle Name:
Authorized Official - Last Name:WITTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-367-3322
Mailing Address - Street 1:PO BOX 110
Mailing Address - Street 2:
Mailing Address - City:DAVID CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68632-0110
Mailing Address - Country:US
Mailing Address - Phone:402-367-3322
Mailing Address - Fax:402-367-3311
Practice Address - Street 1:358 S 10TH ST
Practice Address - Street 2:
Practice Address - City:DAVID CITY
Practice Address - State:NE
Practice Address - Zip Code:68632-2145
Practice Address - Country:US
Practice Address - Phone:402-367-3322
Practice Address - Fax:402-367-3311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care