Provider Demographics
NPI:1114341948
Name:URGENT CARE CLINIC OF LINCOLN, PC
Entity Type:Organization
Organization Name:URGENT CARE CLINIC OF LINCOLN, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:T
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-488-4321
Mailing Address - Street 1:4210 PIONEER WOODS DR
Mailing Address - Street 2:STE A
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-7561
Mailing Address - Country:US
Mailing Address - Phone:402-488-4321
Mailing Address - Fax:402-488-4355
Practice Address - Street 1:4210 PIONEER WOODS DR
Practice Address - Street 2:STE A
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-7561
Practice Address - Country:US
Practice Address - Phone:402-488-4321
Practice Address - Fax:402-488-4355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-14
Last Update Date:2017-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20088207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEDD9926OtherRAILROAD MEDICARE
NEDD9926OtherRAILROAD MEDICARE