Individual
JEROME THOMAS GACKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
15361
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30560
BLUECROSS BLUE SHIELD
NE
01
—
5066
MIDLANDS CHOICE
NE
Enumeration date
08/20/2006
Last updated
07/08/2007
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