Healthcare Provider Details

I. General information

NPI: 1770635104
Provider Name (Legal Business Name): CONSULTANTS IN GASTROENTEROLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 12/23/2021
Certification Date: 12/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 L ST STE 1
LINCOLN NE
68510-2478
US

IV. Provider business mailing address

6900 L ST STE 1
LINCOLN NE
68510-2478
US

V. Phone/Fax

Practice location:
  • Phone: 402-441-5619
  • Fax: 402-441-5606
Mailing address:
  • Phone: 402-441-5600
  • Fax: 402-441-5606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: JODEE HUNT
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 402-441-5619