Provider Demographics
NPI:1902059983
Name:NORFOLK SURGERY-HEHNER PC
Entity type:Organization
Organization Name:NORFOLK SURGERY-HEHNER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLARK
Authorized Official - Middle Name:F
Authorized Official - Last Name:HEHNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-379-1704
Mailing Address - Street 1:109 N 29TH ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-3261
Mailing Address - Country:US
Mailing Address - Phone:402-279-1704
Mailing Address - Fax:
Practice Address - Street 1:109 N 29TH ST
Practice Address - Street 2:SUITE 7
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-3261
Practice Address - Country:US
Practice Address - Phone:402-279-1704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NENA1185Medicare PIN