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General NPI Number Information
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NPI Number | 1497941751
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Entity Type | Organization
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Legal Business Name | SPINE &ORTHOPEDIC SURGERY ASSOCIATES
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Dates
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Enumeration Date | 09/20/2007
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Last Update Date | 11/02/2007
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Provider Practice Location Address
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Address Line | 1215 1ST AVE
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City | KEARNEY
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State | NE
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Zip | 68847-6825
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Country | US
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Telephone | 308-237-0889
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Fax | 308-237-0885
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Provider Business Mailing Address
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Address Line | 1215 1ST AVE
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City | KEARNEY
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State | NE
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Zip | 68847-6825
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Country | US
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Telephone | 308-237-0889
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Fax | 308-237-0885
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DENNIS MCGOWAN
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Credential | M.D.
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Telephone | 308-237-0889
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 20293
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License Number State | NE
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