| Ross Internal Medicine Pc | |
|
2611 S 70th St Suite A Lincoln NE 68506-2960 | |
| (402) 362-7677 | |
| Not Available |
| Full Name | Ross Internal Medicine Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2611 S 70th St, Lincoln, Nebraska |
| Authorized Official Name and Position | Anthony J Ross (PRESIDENT) |
| Authorized Official Contact | 4023627677 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ross Internal Medicine Pc 2611 S 70th St Suite A Lincoln NE 68506-2960 Ph: (402) 362-7677 | Ross Internal Medicine Pc 2611 S 70th St Suite A Lincoln NE 68506-2960 Ph: (402) 362-7677 |
| NPI Number | 1518164243 |
|---|---|
| Provider Enumeration Date | 06/27/2007 |
| Last Update Date | 12/06/2012 |
| Medicare PECOS PAC ID | 0143321661 |
|---|---|
| Medicare Enrollment ID | O20070726000776 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518164243 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
| Provider Name | Kathy L Havlicek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144330457 PECOS PAC ID: 8921103904 Enrollment ID: I20070419000505 |
| Provider Name | Anthony J Ross |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538237250 PECOS PAC ID: 2860593381 Enrollment ID: I20070726000784 |
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