Provider Demographics
NPI:1306955661
Name:KRABBENHOFT, PAUL L (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:L
Last Name:KRABBENHOFT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5401 SOUTH STREET
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-2134
Mailing Address - Country:US
Mailing Address - Phone:402-413-3531
Mailing Address - Fax:402-413-3535
Practice Address - Street 1:5401 SOUTH STREET
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-2134
Practice Address - Country:US
Practice Address - Phone:402-413-3531
Practice Address - Fax:402-413-3535
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20118208100000X, 2081P0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE204651806OtherMISSOURI MEDICAID
NE271000OtherCOVENTRY OF NEBRASKA
NE31191OtherBLUE CROSS BLUE SHIELD
NE100282290AOtherKANSAS MEDICAID
NE4859OtherMIDLANDS CHOICE
NE2300008OtherUNITED HEALTH CARE
NE2300008OtherAMERICHOICE
NE7780860OtherSOUTH DAKOTA MEDICAID
NE250007074OtherMEDICARE RAILROAD
NE982124OtherIOWA MEDICAID
NE7780860OtherSOUTH DAKOTA MEDICAID
NE271000OtherCOVENTRY OF NEBRASKA