Provider Demographics
NPI:1942277405
Name:JERRY K. SEILER, M.D. P.C.
Entity Type:Organization
Organization Name:JERRY K. SEILER, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:SEILER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-463-1355
Mailing Address - Street 1:620 N DENVER AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-5122
Mailing Address - Country:US
Mailing Address - Phone:402-463-1355
Mailing Address - Fax:402-463-6947
Practice Address - Street 1:620 N DENVER AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-5122
Practice Address - Country:US
Practice Address - Phone:402-463-1355
Practice Address - Fax:402-463-6947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15855261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid
NEB67975Medicare UPIN
NE=========00Medicaid