Provider Demographics
NPI:1447434287
Name:SURGICAL ASSOCIATES
Entity type:Organization
Organization Name:SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:KARL
Authorized Official - Last Name:ESKILDSEN
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:308-345-7878
Mailing Address - Street 1:1301 E H ST
Mailing Address - Street 2:P. O. BOX 480
Mailing Address - City:MC COOK
Mailing Address - State:NE
Mailing Address - Zip Code:69001-3482
Mailing Address - Country:US
Mailing Address - Phone:308-345-7878
Mailing Address - Fax:308-345-7879
Practice Address - Street 1:1301 E H ST
Practice Address - Street 2:
Practice Address - City:MC COOK
Practice Address - State:NE
Practice Address - Zip Code:69001-3482
Practice Address - Country:US
Practice Address - Phone:308-345-7878
Practice Address - Fax:308-345-7879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20429208C00000X
KS0427377208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========13Medicaid
NE268945ESMedicare Oscar/Certification
NE=========13Medicaid
KS053348ESMedicare Oscar/Certification