Organization
GREAT PLAINS INTERNAL MEDICINE PC MNE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROY W HOLEYFIELD MD (PRESIDENT)
(402) 242-3987
Entity
Organization
Contact information
Practice address
10135 S 25TH ST, BELLEVUE, NE 68123-1017
(402) 292-3987
(402) 292-4034
Mailing address
10135 S 25TH ST, BELLEVUE, NE 68123-1017
(402) 292-3987
(402) 292-4034
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
110102
NE
207R00000X
Internal Medicine Physician
15518
NE
207R00000X
Internal Medicine Physician
Primary
20728
NE
Other
Enumeration date
06/18/2006
Last updated
04/20/2008
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