Individual
RICHARD A KUTILEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8303 DODGE ST, OMAHA, NE 68114-4108
(402) 354-4344
Mailing address
7701 PACIFIC ST STE 117, OMAHA, NE 68114-5480
(402) 238-1539
(855) 899-5087
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
19134
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209681105
MEDICAID
MO
01
—
3922914
MEDICAID
IA
Enumeration date
07/17/2006
Last updated
10/13/2023
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