Provider Demographics
NPI:1528193158
Name:SOUTHWEST FAMILY PHYSICIANS PC
Entity Type:Organization
Organization Name:SOUTHWEST FAMILY PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:WEEKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-391-3010
Mailing Address - Street 1:8258 HASCALL ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-3248
Mailing Address - Country:US
Mailing Address - Phone:402-391-3010
Mailing Address - Fax:402-391-3076
Practice Address - Street 1:8258 HASCALL ST
Practice Address - Street 2:SUITE 100
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-3248
Practice Address - Country:US
Practice Address - Phone:402-391-3010
Practice Address - Fax:402-391-3076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE16692207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========01Medicaid
NE4404960001Medicare NSC