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Individual

DR. WILLIAM LYDIATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8303 DODGE ST, OMAHA, NE 68114-4108
(402) 354-5048
(402) 354-2585
Mailing address
PO BOX 10190, VIRGINIA BEACH, VA 23450-0190
(800) 336-3038
(757) 463-6572

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
17965
NE
208600000X
Surgery Physician
Primary
17965
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025044400
NE
05
10026485711
NE
05
1578528055
IA
Enumeration date
04/19/2006
Last updated
01/22/2018
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