Basic Information
| Provider Information | |||||||||
| NPI: | 1023002771 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OMAHA EMERGENCY PHYSICIANS PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3366-0210 | ||||||||
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| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681760001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8663218433 | ||||||||
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| Practice Location | |||||||||
| Address1: | 601 N 30TH ST | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681312137 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024494590 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2005 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | GRIGSBY | ||||||||
| AuthorizedOfficialFirstName: | WESLEY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4024494590 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207PE0004X | NE | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services |
No ID Information.