Provider Demographics
NPI:1619951076
Name:ASSOCIATED EAR, NOSE & THROAT PHYSICIANS PC
Entity Type:Organization
Organization Name:ASSOCIATED EAR, NOSE & THROAT PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:TESMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-489-2266
Mailing Address - Street 1:1530 S 70TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-1567
Mailing Address - Country:US
Mailing Address - Phone:402-489-2266
Mailing Address - Fax:402-489-9368
Practice Address - Street 1:1530 S 70TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-1567
Practice Address - Country:US
Practice Address - Phone:402-489-2266
Practice Address - Fax:402-489-9368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========13Medicaid
098510Medicare ID - Type Unspecified