Maynard, Philip A.

Maynard, Philip A. is an sole proprietor health care provider with primary practice located at 416 N Minnesota Ave , Hastings NE 68901-5254. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Foot Surgery, Podiatric Medicine & Surgery Service Providers / Podiatrist. Podiatric Medicine & Surgery Service Providers / Foot Surgery is his primary health care specialty. Maynard, Philip A. can be contacted via phone (402) 462-2788.

Contact Information

Primary practice address
416 N Minnesota Ave Hastings NE 68901-5254
Phone: (402) 462-2788
Fax: (402) 462-4783
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X 159 Nebraska
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 159 Nebraska
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X 00365 Iowa
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 00365 Iowa

Profile Details

NPI number 1619970381
LBN Legal business name Maynard, Philip A.
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 24th, 2005
Last updated Jan 2nd, 2013 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619970381 NPPES
Nebraska Other 02513 BC-BS OF NE
Nebraska Other 480021803 BC-BS OF NE
Nebraska Other 1197710001 BC-BS OF NE
Nebraska MEDICAID 47062581300 BC-BS OF NE

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