Healthcare Provider Details

I. General information

NPI: 1265440747
Provider Name (Legal Business Name): LEON L GEBHARDT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 08/07/2023
Certification Date: 08/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 W NORFOLK AVE
NORFOLK NE
68701-4405
US

IV. Provider business mailing address

3901 W NORFOLK AVE STE D
NORFOLK NE
68701-9218
US

V. Phone/Fax

Practice location:
  • Phone: 402-844-8000
  • Fax: 402-844-8047
Mailing address:
  • Phone: 402-844-8022
  • Fax: 402-844-8047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20447
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: