Individual
KEVIN R GILLESPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7601 PIONEERS BLVD, LINCOLN, NE 68506-4675
(402) 484-6677
(402) 484-4476
Mailing address
7601 PIONEERS BLVD, LINCOLN, NE 68506-4675
(402) 484-6677
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
17602
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
273364
AMI MEDICARE PIN
NE
05
—
47078180813
—
NE
01
—
NA1330011
SMI MEDICARE PIN
NE
Enumeration date
04/14/2006
Last updated
08/13/2016
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