Organization
MD WEST ONE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACIE CHURCH (CFO/BUSINESS MANAGER)
(402) 398-9243
Entity
Organization
Contact information
Practice address
1 EDMUNDSON PL STE 200, COUNCIL BLUFFS, IA 51503-4658
(402) 390-4111
(402) 390-4115
Mailing address
8005 FARNAM DR STE 305, OMAHA, NE 68114-3426
(402) 390-4111
(402) 399-8455
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
07/02/2020
Last updated
08/21/2023
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