Individual
DR. ROBERT M FAULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7950 HARRISON ST, LAVISTA, NE 68128-2912
(402) 592-0711
(402) 934-9242
Mailing address
7950 HARRISON ST, LAVISTA, NE 68128-2912
(402) 592-0711
(402) 934-9242
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
17271
NE
2085R0202X
Diagnostic Radiology Physician
27410
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1118018
—
IA
05
—
47076981613
—
NE
Enumeration date
01/06/2007
Last updated
02/21/2008
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