Organization
LONE TREE MEDICAL ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN SCOT MAHNKE M.D. (CORPORATE OFFICER)
(308) 946-3845
Entity
Organization
Contact information
Practice address
2510 18TH AVE, CENTRAL CITY, NE 68826-2123
(308) 946-3845
(308) 946-2357
Mailing address
2510 18TH AVE, CENTRAL CITY, NE 68826-2123
(308) 946-3845
(308) 946-2357
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
291U00000X
Clinical Medical Laboratory
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025126100
—
NE
01
—
28D0455884
CLIA LABORATORY
NE
01
—
CD8193
RAILROAD MEDICARE
—
Enumeration date
08/20/2006
Last updated
11/26/2012
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