Organization
HEIBEL DERMATOLOGY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK D HEIBEL MD (MD)
(402) 488-6969
Entity
Organization
Contact information
Practice address
7701 PRESERVE LN, LINCOLN, NE 68516-4473
(402) 488-6969
(402) 488-6911
Mailing address
7701 PRESERVE LN, LINCOLN, NE 68516-4473
(402) 488-6969
(402) 488-6911
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
18056
NE
207ND0101X
MOHS-Micrographic Surgery Physician
18056
NE
207ND0900X
Dermatopathology Physician
18056
NE
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
18056
NE
207NP0225X
Pediatric Dermatology Physician
18056
NE
207NS0135X
Procedural Dermatology Physician
18056
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35672
BLUE CROSS BLUE SHIELD
NE
01
—
CK4980
PALMETTO-RAILROAD MEDICAR
NE
Enumeration date
12/28/2006
Last updated
12/11/2014
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