Provider Demographics
NPI:1508881244
Name:HYNES, PHILLIP R (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:R
Last Name:HYNES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 6951
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-0951
Mailing Address - Country:US
Mailing Address - Phone:402-904-7135
Mailing Address - Fax:402-904-7175
Practice Address - Street 1:8001 EIGER DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-6537
Practice Address - Country:US
Practice Address - Phone:402-904-7135
Practice Address - Fax:402-904-7175
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE178312085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE06433OtherBCBS OF NE
77063443668510A003OtherTRI WEST
236134OtherCOVENTRY HEALTH CARE
NEP00226772OtherRAILROAD MEDICARE
NEP00226772OtherRAILROAD MEDICARE
77063443668510A003OtherTRI WEST