Provider Demographics
NPI:1528796356
Name:INPATIENT PHYSICIAN ASSOCIATES GRAND ISLAND LLC
Entity type:Organization
Organization Name:INPATIENT PHYSICIAN ASSOCIATES GRAND ISLAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALISSA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CLOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-481-8566
Mailing Address - Street 1:PO BOX 6971
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-0971
Mailing Address - Country:US
Mailing Address - Phone:402-486-7040
Mailing Address - Fax:402-434-6047
Practice Address - Street 1:3533 PRAIRIEVIEW ST
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4409
Practice Address - Country:US
Practice Address - Phone:402-481-8566
Practice Address - Fax:402-481-8805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty