Provider Demographics
NPI:1821169459
Name:AUBURN FAMILY HEALTH CENTER PC
Entity Type:Organization
Organization Name:AUBURN FAMILY HEALTH CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:R
Authorized Official - Last Name:ENSZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-274-4993
Mailing Address - Street 1:2115 14TH STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AUBURN
Mailing Address - State:NE
Mailing Address - Zip Code:68305-1797
Mailing Address - Country:US
Mailing Address - Phone:402-274-4993
Mailing Address - Fax:402-274-4905
Practice Address - Street 1:2115 14TH STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:AUBURN
Practice Address - State:NE
Practice Address - Zip Code:68305-1797
Practice Address - Country:US
Practice Address - Phone:402-274-4993
Practice Address - Fax:402-274-4905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid
NE=========00Medicaid
NE086100Medicare ID - Type Unspecified