Healthcare Provider Details

I. General information

NPI: 1043241680
Provider Name (Legal Business Name): MATTHEW JAMES LUEDKE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 N 19TH ST
LINCOLN NE
68588-0046
US

IV. Provider business mailing address

11134 N HWY 77
HAYWARD WI
54843
US

V. Phone/Fax

Practice location:
  • Phone: 402-472-5000
  • Fax:
Mailing address:
  • Phone: 715-634-5505
  • Fax: 715-634-5558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35406
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: