Individual
GARY D CUDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
300 N 2ND ST, ONEILL, NE 68763-1519
(402) 336-2900
Mailing address
PO BOX 270, ONEILL, NE 68763-0270
(402) 336-2901
(402) 336-2961
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
633
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0123939
MEDICA
NE
01
—
37387
NEBRASKA BCBS
NE
01
—
3863
MIDLANDS CHOICE
NE
01
—
460423930
TRICARE
NE
05
—
46042393011
—
NE
01
—
7909019
AETNA
NE
01
—
9238079
DAKOTA CARE
NE
Enumeration date
06/01/2005
Last updated
02/15/2012
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