North Platte Nebraska Physician Group Llc
Legal Business Name
North Platte Nebraska Physician Group Llc
NPI Number
1740465715
NPI Type
Organization
Enumeration Date
01/08/2008
Specialties
(Taxonomies)Name
Code
207L00000X
207RE0101X
207RI0200X
2084N0400X
207XS0117X
207LP2900X
208000000X
2084P0800X
208800000X
Primary Taxonomy
No
No
No
No
No
No
No
No
No
Contact
Information
Purpose
Mailing
Location
Address
601 W LEOTA ST
601 W LEOTA ST
City
North Platte
North Platte
State
NE
NE
Postal Code
69101-6525
69101-6525
Country
US
US
Telephone Number
(308) 696-8347
(308) 696-8347
Authorized Official
Name
Mrs. Krystal Claymore
Title or Position
BOARD OF MANAGERS
Telephone Number
(308) 696-7496
Identifiers
Identifier
DN5151
Identifier State
Unknown
Identifier Issuer
RAILROAD MEDICARE
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 06/11/2016