1518145655 NPI number — ORAL PATHOLOGY LABORATORY

Table of content: DR. DEBORAH MAE WILLIAMS DDS (NPI 1467443390)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518145655 NPI number — ORAL PATHOLOGY LABORATORY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORAL PATHOLOGY LABORATORY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518145655
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/12/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 830740
Provider Second Line Business Mailing Address:
40TH AND HOLDREGE ST
Provider Business Mailing Address City Name:
LINCOLN
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68583-0740
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-472-1296
Provider Business Mailing Address Fax Number:
402-472-2551

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4000 HOLDREGE ST ROOM 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LINCOLN
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68583-0740
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-472-1296
Provider Business Practice Location Address Fax Number:
402-472-2551
Provider Enumeration Date:
01/31/2008

Additional Information

Authorized Official

Authorized Official Last Name:
NARAYANA
Authorized Official First Name:
NAGAMANI
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
402-472-1355

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 47078998516 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2026 www.npivalidator.com