Individual
DR. PHILLIP LEE MICKELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6420 56TH AVE, KEARNEY, NE 68845-0380
(308) 224-2062
(888) 974-5962
Mailing address
6420 56TH AVE, KEARNEY, NE 68845-0380
(308) 224-2062
(888) 974-5962
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
107063
MN
207L00000X
Anesthesiology Physician
Primary
32312
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107063
MN MEDICAL LICENSE
MN
05
—
43227252
—
NM
05
—
859457
—
AZ
05
—
86929
—
NM
01
—
967331
PRONET / AETNA
NM
01
—
NM009R60
BLUE CROSS BLUE SHEILD
NM
Enumeration date
05/27/2005
Last updated
01/30/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us