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General NPI Number Information
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NPI Number | 1336290972
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Entity Type | Organization
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Legal Business Name | MCCOOK FAMILY MEDICINE, PC
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 01/19/2025
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Provider Practice Location Address
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Address Line | 1301 E H ST
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City | MC COOK
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State | NE
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Zip | 69001-3482
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Country | US
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Telephone | 308-344-4110
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Fax | 308-344-8369
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Provider Business Mailing Address
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Address Line | PO BOX 1207
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City | MC COOK
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State | NE
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Zip | 69001-1207
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Country | US
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Telephone | 308-344-4110
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | NICHOLE HARTZER
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Credential |
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Telephone | 308-344-8784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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