Healthcare Provider Details

I. General information

NPI: 1427028737
Provider Name (Legal Business Name): HANS M ZINNECKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 09/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 TIBBALS ST
HOLDREGE NE
68949-1255
US

IV. Provider business mailing address

1215 TIBBALS ST
HOLDREGE NE
68949-1255
US

V. Phone/Fax

Practice location:
  • Phone: 507-454-3680
  • Fax:
Mailing address:
  • Phone: 507-454-3680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number24592
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number51554
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number17941
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: