Organization
BLOOMFIELD MEDICAL CLINIC
Active
Parent organization
BLOOMFIELD MEDICAL CLINIC PC
Other names
Bloomfield Medical Clinic DBA Osmond Medical Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
BLOOMFIELD MEDICAL CLINIC PC
Authorized official
KEVIN D LAUCK PA-C (PRESIDENT)
(402) 373-4341
Entity
Organization
Contact information
Practice address
418 N STATE ST, OSMOND, NE 68765-5722
(402) 748-3366
(402) 373-4344
Mailing address
105 S BROADWAY ST, PO BOX 357, BLOOMFIELD, NE 68718-4419
(402) 373-4341
(402) 373-4344
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25844
NE
363A00000X
Physician Assistant
1040
NE
363A00000X
Physician Assistant
2003
NE
363LF0000X
Family Nurse Practitioner
110153
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025588500
—
NE
Enumeration date
09/30/2016
Last updated
09/30/2016
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