Individual
DR. RUSSELL J EBKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2910 BETTEN DR, CRETE, NE 68333-3084
(402) 826-2102
(402) 826-7950
Mailing address
PO BOX 220, CRETE, NE 68333-0220
(402) 826-2102
(402) 826-7950
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17808
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0100475
UNITED HEALTHCARE
NE
01
—
0100476
UNITED HEALTHCARE
NE
01
—
080178127
RAILROAD MEDICARE
NE
01
—
2703
MIDLANDS CHOICE
NE
01
—
35706
BCBS OF NEBRASKA
NE
Enumeration date
05/11/2006
Last updated
09/08/2010
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