Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 01069744A | IN |
Y | 207X00000X | Orthopaedic Surgeon | 28516 | NE |
N | 207XS0106X | Orthopaedic Hand Surgeon | 04-35351 | KS |
N | 207XS0106X | Orthopaedic Hand Surgeon | 2012017425 | MO |
N | 207XS0106X | Orthopaedic Hand Surgeon | 28516 | NE |
NPI | 1285836049 |
---|---|
Provider Name | Daniel Firestone |
First Address | Omaha, NE 68198-8102 |
Second Address | Omaha, NE 68144-5225 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2007 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P01123373 | KS RAILROAD (01) | KS |
P01123376 | MO RAILROAD (01) | MO |