Provider Demographics
NPI:1760545149
Name:MOREHEAD, THOMAS J JR (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:MOREHEAD
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5002 S 24TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68107-2754
Mailing Address - Country:US
Mailing Address - Phone:402-339-2283
Mailing Address - Fax:
Practice Address - Street 1:2281 S 67TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-2809
Practice Address - Country:US
Practice Address - Phone:402-331-0392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1359111N00000X
IN08002466A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE20-4485349OtherUNITED HEALTH CARE
NE246104OtherMIDLANDS CHOICE
NE246104OtherAENTA
NE246104OtherAMERIBAN IEC
NE10025236300Medicaid
NE20-4485349OtherMUTUAL OF OMAHA
NE246104OtherCIGNA
NE09722OtherBLUE CROSS BLUE SHIELD
NE246104OtherAENTA
NE09722OtherBLUE CROSS BLUE SHIELD