Organization
WEDGEWOOD LEGACY MEDICAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES A. FOSNAUGH M.D. (MD)
(402) 489-0334
Entity
Organization
Contact information
Practice address
8055 O ST, STE S-109, LINCOLN, NE 68510-2564
(402) 489-8821
(402) 489-0733
Mailing address
8055 O ST, STE S-109, LINCOLN, NE 68510-2564
(402) 489-0334
(402) 489-0733
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025176100
—
NE
01
—
1902
BCBS
NE
Enumeration date
06/23/2006
Last updated
05/15/2012
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