Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 18235 | NE |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 18235 | NE |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 18235 | NE |
NPI | 1447343405 |
---|---|
Provider Name | Dr. Thomas James Dobleman |
First Address | Omaha, NE 68144-4375 |
Second Address | Omaha, NE 68144-4375 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 06/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02621 | BLUE CROSS BLUE SHIELD NE (01) | NE |
0957373 | (05) | NE |
470778217 | FEDERAL TAX ID (01) | NE |
470778217 | TRICARE (01) | NE |
470778217 | UNITED HEALTH CARE (01) | NE |
47077821700 | (05) | NE |
88384 | COVENTRY (01) | NE |
97053 | BLUE CROSS BLUE SHIELD IA (01) | NE |
C45104 | (02) | NE |