Provider Demographics
NPI:1942270350
Name:DOWNTOWN PHYSICIANS GROUP
Entity Type:Organization
Organization Name:DOWNTOWN PHYSICIANS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHAR-CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-479-7724
Mailing Address - Street 1:1800 O ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68508-1766
Mailing Address - Country:US
Mailing Address - Phone:402-475-7000
Mailing Address - Fax:402-475-6003
Practice Address - Street 1:1800 O ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-1766
Practice Address - Country:US
Practice Address - Phone:402-475-7000
Practice Address - Fax:402-475-6003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========13Medicaid
NE=========13Medicaid