Provider Demographics
NPI:1174243489
Name:PRAIRIE ORTHOPAEDIC & PLASTIC SURGERY, PC
Entity type:Organization
Organization Name:PRAIRIE ORTHOPAEDIC & PLASTIC SURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:T
Authorized Official - Last Name:HURLBUT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-489-4700
Mailing Address - Street 1:4130 PIONEER WOODS DR STE 1
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-7552
Mailing Address - Country:US
Mailing Address - Phone:402-489-4700
Mailing Address - Fax:402-489-5220
Practice Address - Street 1:5901 N 28TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-9820
Practice Address - Country:US
Practice Address - Phone:402-489-4700
Practice Address - Fax:402-489-5220
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRAIRIE ORTHOPAEDIC & PLASTIC SURGERY, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies