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General NPI Number Information
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NPI Number | 1639206147
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Entity Type | Organization
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Legal Business Name | PRAIRIE ORTHOPAEDIC & PLASTIC SURGERY, P.C.
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 08/19/2022
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Provider Practice Location Address
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Address Line | 4130 PIONEER WOODS DR SUITE 1
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City | LINCOLN
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State | NE
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Zip | 68506-7551
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Country | US
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Telephone | 402-489-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 4130 PIONEER WOODS DR STE 1
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City | LINCOLN
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State | NE
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Zip | 68506-7552
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Country | US
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Telephone | 402-489-4700
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Fax | 402-489-5220
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Authorized Official
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Title or Position | PHYSICIAN-OWNER
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Name | DR. PATRICK T HURLBUT
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Credential | MD
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Telephone | 402-489-4700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1739
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 19446
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License Number State | NE
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