Provider Demographics
NPI:1598855298
Name:MCGOWAN, DENNIS PATRICK (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:PATRICK
Last Name:MCGOWAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-6825
Mailing Address - Country:US
Mailing Address - Phone:308-237-0889
Mailing Address - Fax:308-237-0885
Practice Address - Street 1:1215 1ST AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-6825
Practice Address - Country:US
Practice Address - Phone:308-237-0889
Practice Address - Fax:308-237-0885
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20293207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
270798MCMedicare ID - Type Unspecified
B75097Medicare UPIN