Provider Demographics
NPI:1912043803
Name:BELITZ, JOHN F (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:BELITZ
Suffix:
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 1:11223 WRIGHT CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-4736
Mailing Address - Country:US
Mailing Address - Phone:402-333-4848
Mailing Address - Fax:402-333-0595
Practice Address - Street 1:11223 WRIGHT CIR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-4736
Practice Address - Country:US
Practice Address - Phone:402-333-4848
Practice Address - Fax:402-333-0595
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1086111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE88043309900Medicaid
IA0593905OtherIOWA MEDICAID
NE09779OtherBLUE CROSS-NON PROVIDER
NEU51145Medicare UPIN
NE272147Medicare ID - Type Unspecified