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Organization
LONE TREE MEDICAL ASSOCIATES, P.C.
Active
Organization
LONE TREE MEDICAL ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN SCOT MAHNKE M.D. (CORPORATE OFFICER)
(308) 946-3845
Entity
Organization
Contact information
Practice address
2510 18TH AVE, CENTRAL CITY, NE 68826-2123
(308) 946-3845
(308) 946-2357
Mailing address
2510 18TH AVE, CENTRAL CITY, NE 68826-2123
(308) 946-3845
(308) 946-2357
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
NULL
291U00000X
Clinical Medical Laboratory
—
NULL
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025126100
—
NE
01
—
28D0455884
CLIA LABORATORY
NE
01
—
CD8193
RAILROAD MEDICARE
—
Enumeration date
08/20/2006
Last updated
11/26/2012
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