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Great Plains N Urology Pc
Specialist in Imperial, Nebraska
NPI 1770609232

Great Plains N Urology Pc is a Specialist based in Rapid City, NE. Great Plains N Urology Pc practices in Imperial, NE. The NPI Number for Great Plains N Urology Pc is 1770609232 and holds a License No. 22506 (Nebraska).

The current practice location address for Great Plains N Urology Pc is 600 W 12Th St, Imperial, NE and can be reached out via phone at 308-414-1968 and via fax at 308-534-3404.

Location: 600 W 12Th St, Imperial, NE, 57709-1542
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1770609232
Provider Name
Great Plains N Urology Pc
Credential
Provider Entity Type
Organization
Address
600 W 12Th St, Imperial, NE, 57709-1542
Phone Number
308-414-1968
Fax Number
308-534-3404
Provider Enumeration Date
03/22/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100263002-00 05 NE
099638002 01 MEDICARE
100250070-00 05 NE
institution
Provider Business Practice Location Address Details
Address
600 W 12Th St
City
Imperial
State
Nebraska
Zip
69033-3130
Phone Number
308-414-1968
Fax Number
308-534-3404
person
Provider Business Mailing Address Details
Address
600 W 12Th St
City
Imperial
State
Nebraska
Zip
69033-3130
Phone Number
308-414-1968
Fax Number
308-534-3404
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
22506 (Nebraska)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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