Provider Demographics
NPI:1225213283
Name:BRITT A THEDINGER MD PC
Entity Type:Organization
Organization Name:BRITT A THEDINGER MD PC
Other - Org Name:EAR SPECIALISTS OF OMAHA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BRITT
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:THEDINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-933-3277
Mailing Address - Street 1:8005 FARNAM DR
Mailing Address - Street 2:STE 206
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3426
Mailing Address - Country:US
Mailing Address - Phone:402-933-3277
Mailing Address - Fax:402-933-2216
Practice Address - Street 1:8005 FARNAM DR
Practice Address - Street 2:STE 206
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3426
Practice Address - Country:US
Practice Address - Phone:402-933-3277
Practice Address - Fax:402-933-2216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
NE18188332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE0654690001Medicare NSC