Wedgewood Legacy Medical P.C.

LBN: Wedgewood Legacy Medical P.C.
Wedgewood Legacy Medical P.C. is an health care organization with primary practice located at 8055 O St Ste S-109, Lincoln NE 68510-2564. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Wedgewood Legacy Medical P.C. can be contacted via phone (402) 489-8821, or through Fosnaugh, James A. via phone (402) 489-0334.

Contact Information

Primary practice address
8055 O St Ste S-109 Lincoln NE 68510-2564
Phone: (402) 489-8821
Fax: (402) 489-0733
Website:
Map and Directions
Authorized official contact:
Name: Fosnaugh, James A. Doctor of Medicine (MD)
Phone: (402) 489-0334

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X

Profile Details

NPI number 1053347187
LBN Legal business name Wedgewood Legacy Medical P.C.
DBA Doing business as
Authorized official Fosnaugh, James A. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 23rd, 2006
Last updated May 15th, 2012 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053347187 NPPES
Nebraska MEDICAID 10025176100
Nebraska Other 1902

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