Provider Demographics
NPI:1811004252
Name:HURLBUT, GREGGORY S (MD)
Entity type:Individual
Prefix:
First Name:GREGGORY
Middle Name:S
Last Name:HURLBUT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3201 PIONEERS BLVD STE 304
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-5963
Mailing Address - Country:US
Mailing Address - Phone:402-483-2987
Mailing Address - Fax:402-483-2987
Practice Address - Street 1:3201 PIONEERS BLVD STE 304
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-5963
Practice Address - Country:US
Practice Address - Phone:402-483-2987
Practice Address - Fax:402-483-2987
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE15755207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47068394113Medicaid
NE03262OtherBCBS
080028071OtherMEDICARE RAILROAD
0931200001Medicare NSC
NE03262OtherBCBS
E43011Medicare UPIN