| Bott Pc | |
|
11810 Nicholas St Ste 101 Omaha NE 68154-4414 | |
| (402) 779-8400 | |
| (402) 779-8401 |
| Full Name | Bott Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 11810 Nicholas St Ste 101, Omaha, Nebraska |
| Authorized Official Name and Position | Matthew S Bott (PRESIDENT) |
| Authorized Official Contact | 4027798400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bott Pc 11810 Nicholas St Ste 101 Omaha NE 68154-4414 Ph: (402) 779-8400 | Bott Pc 11810 Nicholas St Ste 101 Omaha NE 68154-4414 Ph: (402) 779-8400 |
| NPI Number | 1003284050 |
|---|---|
| Provider Enumeration Date | 09/08/2015 |
| Last Update Date | 05/22/2019 |
| Medicare PECOS PAC ID | 3779893276 |
|---|---|
| Medicare Enrollment ID | O20151113000145 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003284050 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Matthew Solon Bott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982613790 PECOS PAC ID: 1557335643 Enrollment ID: I20040824000906 |
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