Organization
NILA MOORE NOVOTNY
Active
Other names
Columbus Otolaryngology Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
NILA M NOVOTNY M.D. (PROPRIETOR)
(402) 563-4500
Entity
Organization
Contact information
Practice address
4508 38TH ST, SUITE #152, COLUMBUS, NE 68601-1668
(402) 563-4500
(402) 563-3520
Mailing address
4508 38TH ST, STE 152, COLUMBUS, NE 68601-1668
(402) 563-4500
(402) 563-3520
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
17352
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01923
BLUE CROSS GROUP #
NE
05
—
10025979300
—
NE
01
—
1538141593
TRIWEST
NE
Enumeration date
11/16/2005
Last updated
03/13/2012
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