Provider Demographics
NPI:1801176532
Name:BROGAN, BYRON JAMES (ESQ)
Entity type:Individual
Prefix:MR
First Name:BYRON
Middle Name:JAMES
Last Name:BROGAN
Suffix:
Gender:M
Credentials:ESQ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 W NORFOLK AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5006
Mailing Address - Country:US
Mailing Address - Phone:402-370-3140
Mailing Address - Fax:402-844-3400
Practice Address - Street 1:900 W NORFOLK AVE STE 200
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-5006
Practice Address - Country:US
Practice Address - Phone:402-370-3140
Practice Address - Fax:402-844-3400
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator