Koefoot, Richard Bruce

Koefoot, Richard Bruce is an individual health care provider with primary practice located at 620 N Alpha St , Grand Island NE 68803-4316. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Koefoot, Richard Bruce can be contacted via phone (308) 381-0473.

Contact Information

Primary practice address
620 N Alpha St Grand Island NE 68803-4316
Phone: (308) 381-0473
Fax: (308) 381-2616
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 18143 Nebraska

Profile Details

NPI number 1003896010
LBN Legal business name Koefoot, Richard Bruce
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2006
Last updated Jan 28th, 2010 - about 15 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 1003896010 NPPES
Nebraska Other 00378 BLUE CROSS
Nebraska Other 247460 BLUE CROSS
Nebraska Other P00241093 BLUE CROSS

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