Individual
DR. THOMAS N FENNESSY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2501 LAKERIDGE DR STE 104, NORFOLK, NE 68701-2558
(402) 368-9964
(402) 368-5675
Mailing address
2900 MIMICK DR, NORFOLK, NE 68701-3350
(402) 992-0659
(402) 625-0005
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
22583
NE
207Q00000X
Family Medicine Physician
34333
IA
207Q00000X
Family Medicine Physician
Primary
5291
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01724
BCBS
NE
Enumeration date
07/31/2006
Last updated
02/12/2025
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