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General NPI Number Information
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NPI Number | 1215979802
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Entity Type | Organization
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Legal Business Name | NEBRASKA NEUROSURGERY & SPINE CLINIC P C
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 08/24/2017
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Provider Practice Location Address
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Address Line | 3219 CENTRAL AVE SUITE 103
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City | KEARNEY
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State | NE
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Zip | 68847-2949
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Country | US
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Telephone | 308-234-9822
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Fax |
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Provider Business Mailing Address
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Address Line | 3219 CENTRAL AVE SUITE 103
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City | KEARNEY
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State | NE
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Zip | 68847-2949
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Country | US
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Telephone | 308-234-9822
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ADELEKE E BADEJO
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Credential | M.D., FACS
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Telephone | 308-234-9822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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