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General NPI Number Information
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NPI Number | 1831283951
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Entity Type | Organization
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Legal Business Name | GREAT PLAINS FOOT AND ANKLE SPECIALISTS PC
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 01/30/2019
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Provider Practice Location Address
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Address Line | 815 S MAPLE ST
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City | NORTH PLATTE
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State | NE
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Zip | 69101-5282
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Country | US
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Telephone | 308-532-3600
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Fax | 308-532-6288
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Provider Business Mailing Address
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Address Line | 815 S MAPLE ST
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City | NORTH PLATTE
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State | NE
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Zip | 69101-5282
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Country | US
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Telephone | 308-532-3600
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Fax | 308-532-6288
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Authorized Official
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Title or Position | INSURANCE BILLING SPECIALIST
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Name | DEBORAH C MATSON
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Credential |
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Telephone | 308-532-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 235
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License Number State | NE
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