Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 25144 | NE |
Y | 208600000X | Surgeon | 25144 | NE |
N | 2086S0102X | Surgical Critical Care | 25144 | NE |
NPI | 1316107444 |
---|---|
Provider Name | Stanley E Okosun |
First Address | Lincoln, NE 68506-7250 |
Second Address | Lincoln, NE 68502-3704 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2008 |
Last Update Date | 24/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10025037900 | (05) | NE |
13914 | BCBS (01) | NE |
200634870A | (05) | KS |
47077696002 | (05) | NE |
N/A | (05) | IA |
P00739812 | RAILROAD MEDICARE (01) | NE |