Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 18448 | NE |
Y | 208600000X | Surgeon | 18448 | NE |
N | 2086X0206X | Surgical Oncologist | 18448 | NE |
NPI | 1114037439 |
---|---|
Provider Name | Dr. James A Reilly |
First Address | Omaha, NE 68103-0755 |
Second Address | Omaha, NE 68114-4129 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 03/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1114037439 | (05) | IA |
47068731707 | (05) | NE |
F29575 | (02) |