Provider Demographics
NPI:1629159553
Name:SARPY COUNTY OB/GYN, PC
Entity Type:Organization
Organization Name:SARPY COUNTY OB/GYN, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AO
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCFADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-898-8500
Mailing Address - Street 1:8419 S 73RD PLZ STE 107
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-1507
Mailing Address - Country:US
Mailing Address - Phone:402-898-8500
Mailing Address - Fax:402-898-8510
Practice Address - Street 1:8419 S 73RD PLZ STE 107
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-1507
Practice Address - Country:US
Practice Address - Phone:402-898-8500
Practice Address - Fax:402-898-8510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NECJ5528OtherRAILROAD MEDICARE
NE1629159553OtherRAILROAD MEDICARE
NECJ5528OtherRAILROAD MEDICARE
NE=========13Medicaid