Provider Demographics
NPI:1548429962
Name:UNMC PHYCISIANS
Entity Type:Organization
Organization Name:UNMC PHYCISIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER CT SURGERY
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:RHEAULT
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:402-559-4469
Mailing Address - Street 1:2 TUDOR CITY PL APT 5HS
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-6828
Mailing Address - Country:US
Mailing Address - Phone:516-384-3685
Mailing Address - Fax:
Practice Address - Street 1:NEBRASKA MEDICAL CENTER THORACIC SURGERY
Practice Address - Street 2:982315 NEBRASKA MEDICAL CENTER
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-0001
Practice Address - Country:US
Practice Address - Phone:402-559-4469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY240838282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital