Healthcare Provider Details

I. General information

NPI: 1568456903
Provider Name (Legal Business Name): HEALTHSERVICESONE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 CENTRAL AVE SUITE C
KEARNEY NE
68847-2944
US

IV. Provider business mailing address

PO BOX 2168 3500 CENTRAL AVE SUITE C
KEARNEY NE
68848-2168
US

V. Phone/Fax

Practice location:
  • Phone: 308-865-2500
  • Fax: 308-865-2506
Mailing address:
  • Phone: 308-865-2500
  • Fax: 308-865-2506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number76009
License Number StateNE

VIII. Authorized Official

Name: CHRIS E WILKINSON
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 308-865-2500