Healthcare Provider Details

I. General information

NPI: 1881704245
Provider Name (Legal Business Name): FAMILY PHYSICIANS OF PLATTSMOUTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2302 8TH AVE SUITE 3
PLATTSMOUTH NE
68048-2365
US

IV. Provider business mailing address

PO BOX 6971
LINCOLN NE
68506-0971
US

V. Phone/Fax

Practice location:
  • Phone: 402-296-4453
  • Fax: 402-296-5154
Mailing address:
  • Phone: 402-296-4453
  • Fax: 402-296-5154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LAWRENCE ALGOT CARLSSON JR.
Title or Position: OWNER
Credential: MD
Phone: 402-296-4453