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General NPI Number Information
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NPI Number | 1013187624
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Entity Type | Organization
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Legal Business Name | CENTRAL PLAINS PLASTIC & RECONSTRUCTIVE SURGERY, PC
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Dates
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Enumeration Date | 03/11/2008
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Last Update Date | 04/29/2015
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Provider Practice Location Address
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Address Line | 3712 28TH AVENUE
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City | KEARNEY
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State | NE
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Zip | 68845
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Country | US
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Telephone | 308-865-2737
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Fax |
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Provider Business Mailing Address
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Address Line | 3712 28TH AVENUE
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City | KEARNEY
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State | NE
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Zip | 68845
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Country | US
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Telephone | 308-865-2737
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOEL ROBERT ATCHSION
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Credential | MD
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Telephone | 308-865-2737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 20766
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License Number State | NE
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