Healthcare Provider Details

I. General information

NPI: 1689401283
Provider Name (Legal Business Name): COLLIN MCPARTLAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2024
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 MAIN ST
WAYNE NE
68787-1172
US

IV. Provider business mailing address

307 S NEBRASKA ST APT A
WAYNE NE
68787-2112
US

V. Phone/Fax

Practice location:
  • Phone: 402-375-7310
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PS0010X
TaxonomySports Medicine (Emergency Medicine) Physician
License Number1151
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: