Healthcare Provider Details

I. General information

NPI: 1629159553
Provider Name (Legal Business Name): SARPY COUNTY OB/GYN, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 11/20/2020
Certification Date: 11/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8419 S 73RD PLZ STE 107
PAPILLION NE
68046-1507
US

IV. Provider business mailing address

8419 S 73RD PLZ STE 107
PAPILLION NE
68046-1507
US

V. Phone/Fax

Practice location:
  • Phone: 402-898-8500
  • Fax: 402-898-8510
Mailing address:
  • Phone: 402-898-8500
  • Fax: 402-898-8510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SEAN MCFADDEN
Title or Position: AO
Credential: MD
Phone: 402-898-8500