Provider Demographics
NPI:1447343405
Name:DOBLEMAN, THOMAS JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JAMES
Last Name:DOBLEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11704 W CENTER RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-4375
Mailing Address - Country:US
Mailing Address - Phone:402-393-7050
Mailing Address - Fax:402-393-2814
Practice Address - Street 1:11704 W CENTER RD
Practice Address - Street 2:SUITE 211
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-4375
Practice Address - Country:US
Practice Address - Phone:402-393-7050
Practice Address - Fax:402-393-2814
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE18235207Y00000X, 207YX0007X, 207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
No207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE0957373Medicaid
NE88384OtherCOVENTRY
NE97053OtherBLUE CROSS BLUE SHIELD IA
NE470778217OtherUNITED HEALTH CARE
NE470778217OtherFEDERAL TAX ID
NE47077821700Medicaid
NE02621OtherBLUE CROSS BLUE SHIELD NE
NE470778217OtherTRICARE
NE02621OtherBLUE CROSS BLUE SHIELD NE
NE470778217OtherTRICARE