Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 036-112826 | IL |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 24529 | NE |
N | 2081P2900X | Pain Medicine | 036-112826 | IL |
Y | 2081P2900X | Pain Medicine | 24529 | NE |
NPI | 1144338286 |
---|---|
Provider Name | Dr. Wesley L. Smeal |
First Address | Omaha, NE 68122 |
Second Address | Omaha, NE 68130 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2006 |
Last Update Date | 29/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036112826 | (05) | IL |
47037661525 | (05) | NE |
I60384 | (02) |