Provider Demographics
NPI:1225369531
Name:PLUM CREEK SURGERY, PC
Entity Type:Organization
Organization Name:PLUM CREEK SURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KERREY
Authorized Official - Middle Name:B
Authorized Official - Last Name:BUSER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:308-324-5660
Mailing Address - Street 1:1101 BUFFALO BND
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68850-1528
Mailing Address - Country:US
Mailing Address - Phone:308-324-5660
Mailing Address - Fax:308-324-5728
Practice Address - Street 1:1101 BUFFALO BND
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NE
Practice Address - Zip Code:68850-1528
Practice Address - Country:US
Practice Address - Phone:308-324-5660
Practice Address - Fax:308-324-5728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE19903208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE19903OtherNE MEDICAL LICENSE
B92644Medicare UPIN
NE19903OtherNE MEDICAL LICENSE