Clyde, Brent Lee
Clyde, Brent Lee is an sole proprietor health care provider with primary practice located at 7710 Mercy Rd Ste 2000 , Omaha NE 68124-2323. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Neurological Surgery. Allopathic & Osteopathic Physicians / Neurological Surgery is his primary health care specialty. Clyde, Brent Lee can be contacted via phone (402) 717-0880.Contact Information
Primary practice address
7710 Mercy Rd Ste 2000
Omaha NE 68124-2323
Phone: (402) 717-0880
Fax: (402) 717-0880
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 4821912-1205 | Utah |
| Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | EMC0002923 | Michigan |
| Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | 31812 | Nebraska |
Profile Details
| NPI number | 1700896552 |
|---|---|
| LBN Legal business name | Clyde, Brent Lee |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 8th, 2006 |
| Last updated | Jun 14th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700896552 | NPPES |
| Wyoming | MEDICAID | 1174436 00 |
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