Provider Demographics
NPI:1730320722
Name:NOBLE SPINE CENTRE PC
Entity Type:Organization
Organization Name:NOBLE SPINE CENTRE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:NOBLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-484-4845
Mailing Address - Street 1:PO BOX 80408
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68501-0408
Mailing Address - Country:US
Mailing Address - Phone:405-947-5557
Mailing Address - Fax:
Practice Address - Street 1:4220 PIONEER WOODS DR
Practice Address - Street 2:STE B
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-7564
Practice Address - Country:US
Practice Address - Phone:402-484-4845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-20
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1927207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty