Provider Demographics
NPI:1972553584
Name:BABBITT, TIMOTHY DANIEL (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:DANIEL
Last Name:BABBITT
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 1:2700 W NORFOLK AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-4438
Mailing Address - Country:US
Mailing Address - Phone:402-644-7543
Mailing Address - Fax:402-644-7503
Practice Address - Street 1:2700 W NORFOLK AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-4438
Practice Address - Country:US
Practice Address - Phone:402-644-7543
Practice Address - Fax:402-644-7503
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE23039207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00177175OtherRAILROAD MEDICARE
NE39-02020OtherSHAREADVANTAGE
IA0588939Medicaid
NE39-02021OtherSHAREADVANTAGE MEDICAID
06208OtherBCBS
NE245258OtherMLDCH AND MUTLOF OMAHA
NE100251217-00Medicaid
IA2588939Medicaid
NEP00177175OtherRAILROAD MEDICARE
NE100249951-00Medicaid
NEH65690Medicare UPIN
NE100251217-00Medicaid