Provider Demographics
NPI:1205861788
Name:OMAHA CENTER FOR SURGERY, P.C.
Entity Type:Organization
Organization Name:OMAHA CENTER FOR SURGERY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.O./PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:402-552-3078
Mailing Address - Street 1:4242 FARNAM ST
Mailing Address - Street 2:#370
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2806
Mailing Address - Country:US
Mailing Address - Phone:402-552-3078
Mailing Address - Fax:402-552-3075
Practice Address - Street 1:4242 FARNAM ST
Practice Address - Street 2:#370
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2806
Practice Address - Country:US
Practice Address - Phone:402-552-3078
Practice Address - Fax:402-552-3075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10024993900Medicaid
NE10024993900Medicaid