Individual
KENNETH L BLAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2727 S 144TH ST, #280, OMAHA, NE 68144-5225
(402) 778-5490
(402) 614-1404
Mailing address
2727 S 144TH ST, #280, OMAHA, NE 68144-5225
(402) 778-5490
(402) 614-1404
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21848
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10024982500
—
NE
Enumeration date
02/20/2006
Last updated
05/13/2014
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