Healthcare Provider Details

I. General information

NPI: 1902091671
Provider Name (Legal Business Name): GREATER SANDHILLS FAMILY HEALTHCARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 E 5TH ST
ATKINSON NE
68713-4885
US

IV. Provider business mailing address

PO BOX 403
ATKINSON NE
68713-0403
US

V. Phone/Fax

Practice location:
  • Phone: 402-925-2994
  • Fax: 402-925-2996
Mailing address:
  • Phone: 402-924-3660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number22198
License Number StateNE

VIII. Authorized Official

Name: DR. JOHN D TUBBS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 402-924-3660