Organization
SURGERY ADULT PEDIATRIC VASCULAR P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY W BARTH MD (OWNER)
(402) 462-5555
Entity
Organization
Contact information
Practice address
2115 N KANSAS AVE, SUITE 107, HASTINGS, NE 68901-2615
(402) 462-2330
Mailing address
PO BOX 249, SUITE 107, HASTINGS, NE 68902-0249
(402) 462-2330
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
14009
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04256
BLUE CROSS BLUE SHIELD
NE
01
—
2009
MIDLAND CHOICE
NE
Enumeration date
11/21/2007
Last updated
04/12/2010
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