Provider Demographics
NPI:1508850090
Name:WESTERN SURGICAL GROUP, PC
Entity Type:Organization
Organization Name:WESTERN SURGICAL GROUP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROMMIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:308-632-2872
Mailing Address - Street 1:2 W 42ND ST
Mailing Address - Street 2:SUITE 3100
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-0615
Mailing Address - Country:US
Mailing Address - Phone:308-632-2872
Mailing Address - Fax:308-632-4191
Practice Address - Street 1:2 W 42ND ST
Practice Address - Street 2:SUITE 3100
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-0615
Practice Address - Country:US
Practice Address - Phone:308-632-2872
Practice Address - Fax:308-632-4191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========12Medicaid
NE=========12Medicaid