Provider Demographics
NPI:1427089838
Name:GREAT PLAINS RADIOLOGY & NUCLEAR MEDICINE PC
Entity type:Organization
Organization Name:GREAT PLAINS RADIOLOGY & NUCLEAR MEDICINE PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:HADFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:308-398-6400
Mailing Address - Street 1:PO BOX 2435
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68848-2435
Mailing Address - Country:US
Mailing Address - Phone:308-398-6400
Mailing Address - Fax:308-398-6408
Practice Address - Street 1:10 E 31ST ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-2918
Practice Address - Country:US
Practice Address - Phone:308-398-6400
Practice Address - Fax:308-398-6408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DD1822OtherRRMC GROUP KIFER
DF9130OtherRRMC GROUP TEXAS
88197OtherCOVENTRY
NE2825OtherBCBS
KS94857OtherBCBS
KS100213600AMedicaid
C04216OtherRAILROAD MEDICARE
=========OtherMIDLANDS CHOICE
88197OtherCOVENTRY
KS94857OtherBCBS
NE=========00Medicaid
KSS520000Medicare PIN