# NORTH PLATTE REGIONAL UROLOGY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497892673
- **Authorized official:** MICHAEL GALLENTINE (UROLOGIST SOLE PROPRIETOR OWNER)
- **Authorized official phone:** (719) 393-2137

## Contact information

- **Practice address:** 611 W FRANCIS ST, NORTH PLATTE, NE 69101-0620
- **Practice address phone:** (719) 393-2137
- **Mailing address:** 4455 STONEHAVEN DR, COLORADO SPRINGS, CO 80906-4897

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 20757 | NE | Yes |

## Other

- **Enumeration date:** 01/30/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1356311583 | PERSONAL NPI | — |