| NPI | 1174654321 |
|---|---|
| Former Legal Business Name | SOUTH LINCOLN MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | ANTHONY J ROSS President 402-486-3444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 20387) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 14394) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: NE 18104) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |