| Wedgewood Legacy Medical P.c. | |
|
8055 O St Ste S-109 Lincoln NE 68510-2564 | |
| (402) 489-8821 | |
| (402) 489-0733 |
| Full Name | Wedgewood Legacy Medical P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 8055 O St, Lincoln, Nebraska |
| Authorized Official Name and Position | James A. Fosnaugh (MD) |
| Authorized Official Contact | 4024890334 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wedgewood Legacy Medical P.c. 8055 O St Ste S-109 Lincoln NE 68510-2564 Ph: (402) 489-0334 | Wedgewood Legacy Medical P.c. 8055 O St Ste S-109 Lincoln NE 68510-2564 Ph: (402) 489-8821 |
| NPI Number | 1053347187 |
|---|---|
| Provider Enumeration Date | 06/23/2006 |
| Last Update Date | 05/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053347187 | NPI | - | NPPES |
| 10025176100 | Medicaid | NE | |
| 1902 | Other | NE | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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