Provider Demographics
NPI:1699867341
Name:SAFRANEK, THOMAS JEROME (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JEROME
Last Name:SAFRANEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2421 RYONS ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-4025
Mailing Address - Country:US
Mailing Address - Phone:402-471-0550
Mailing Address - Fax:402-471-3601
Practice Address - Street 1:2421 RYONS ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-4025
Practice Address - Country:US
Practice Address - Phone:402-471-0550
Practice Address - Fax:402-471-3601
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE16159207RI0200X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Not Answered2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NED17298Medicare UPIN