Facts
- Status
- A
- Credential
- M.D.
- Type
- Individual
- Enumeration date
- 2007-04-20
- Last updated
- 2026-10-08
Specialties
- 2085R0202XRadiology, Diagnostic Radiology
- 2085R0202XRadiology, Diagnostic Radiology
- 2085R0202XRadiology, Diagnostic Radiology
- 2085R0202XRadiology, Diagnostic Radiology
- 2085R0202XRadiology, Diagnostic Radiology
- 2085R0202XRadiology, Diagnostic Radiology
- 2085R0202XRadiology, Diagnostic Radiology
- 2085R0202XRadiology, Diagnostic Radiology
Licenses
- License NV
- 29330
- License OR
- 228062
- License CO
- DR.0071266
- License TX
- W1553
- License NE
- 24353
- License IL
- 036.176820
- License IA
- MD-48251
- License SC
- 97838
Location
- Practice location
- 10 E 31ST ST
- City
- KEARNEY NE
- Postal code
- 688472918
- Phone
- 308-865-7900
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
Search this city from the state hub for other records in the public registry.
Removal request
Public data from NPPES and CMS. Not a credentialing determination.