# CENTRAL NEBRASKA MEDICAL CLINIC AT SARGENT

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CENTRAL NEBRASKA MEDICAL CLINIC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1861513954
- **Legal business name:** CENTRAL NEBRASKA MEDICAL CLINIC
- **Authorized official:** DR. DAVID A MINNICK M.D. (OWNER)
- **Authorized official phone:** (308) 872-2486

## Contact information

- **Practice address:** 404 W MAIN ST, SARGENT, NE 68874-6101
- **Practice address phone:** (308) 527-4300
- **Practice address fax:** (308) 527-9106
- **Mailing address:** 404 W MAIN ST, SARGENT, NE 68874-6101
- **Mailing address phone:** (308) 527-4300
- **Mailing address fax:** (308) 527-9106

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NE | Yes |

## Other

- **Enumeration date:** 04/03/2007
- **Last updated:** 09/17/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 28D0962195 | CLIA NUMBER | NE |