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Organization
GRAND ISLAND CLINIC INC
Active
Organization
GRAND ISLAND CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS J HERBEK M.D. (PHYSICIAN)
(308) 382-1100
Entity
Organization
Contact information
Practice address
2444 W FAIDLEY AVE, GRAND ISLAND, NE 68803-4327
(130) 838-2110
(308) 385-0796
Mailing address
PO BOX 550, GRAND ISLAND, NE 68802-0550
(308) 382-1100
(308) 385-0796
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
NULL
2085R0202X
Diagnostic Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10028822400
—
NE
01
—
CO4245
PALMETTO GBA
NE
Enumeration date
08/10/2005
Last updated
07/30/2024
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