Organization
GOTHENBURG FAMILY PRACTICE RURAL HEALTH CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD E MATZKE JR. M.D. (PARTNER)
(308) 537-7131
Entity
Organization
Contact information
Practice address
918 20TH STREET, GOTHENBURG, NE 69138-1237
(308) 537-7131
(308) 537-7310
Mailing address
918 20TH STREET, GOTHENBURG, NE 69138-1237
(308) 537-7131
(308) 537-7310
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
10025929400
NE
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025929400
—
NE
01
—
60387
BC/BS
NE
01
—
60387
BC/BS
—
Enumeration date
02/03/2010
Last updated
04/13/2012
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