Provider Demographics
NPI:1881659787
Name:BOECK, CURTIS LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:LEE
Last Name:BOECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7261 MERCY RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2311
Mailing Address - Country:US
Mailing Address - Phone:402-449-4847
Mailing Address - Fax:402-449-4885
Practice Address - Street 1:601 N 30TH ST
Practice Address - Street 2:SUITE 3222
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2128
Practice Address - Country:US
Practice Address - Phone:402-449-4847
Practice Address - Fax:402-449-4885
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA32453207L00000X
NE208038207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI21224OtherMEDICARE-MERCY
NE470550438Medicaid
NE10025745600Medicaid
NE098713OtherMEDICARE-IMC/BERGAN
NE10025709900Medicaid
IA10025507800Medicaid
NENA1324OtherMEDICARE-MIDLANDS