# BOTT PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003284050
- **Authorized official:** MATTHEW S BOTT MD (PRESIDENT)
- **Authorized official phone:** (402) 779-8400

## Contact information

- **Practice address:** 11810 NICHOLAS ST STE 101, OMAHA, NE 68154-4414
- **Practice address phone:** (402) 779-8400
- **Practice address fax:** (402) 779-8401
- **Mailing address:** 11810 NICHOLAS ST STE 101, OMAHA, NE 68154-4414
- **Mailing address phone:** (402) 779-8400
- **Mailing address fax:** (402) 779-8401

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/08/2015
- **Last updated:** 05/22/2019