Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 20180 | NE |
NPI | 1023031036 |
---|---|
Provider Name | Dr. Thomas J Connolly |
First Address | Omaha, NE 68131-2136 |
Second Address | Boys Town, NE 68010-7521 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 25/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G39417 | (02) | NE |