Provider Demographics
NPI:1538183207
Name:WESTERN ENT ASSOCIATES, PC
Entity type:Organization
Organization Name:WESTERN ENT ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:MASSEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:308-635-3155
Mailing Address - Street 1:2 W 42ND ST
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-4669
Mailing Address - Country:US
Mailing Address - Phone:308-635-3155
Mailing Address - Fax:308-635-2966
Practice Address - Street 1:2 W 42ND ST
Practice Address - Street 2:SUITE 1100
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-4669
Practice Address - Country:US
Practice Address - Phone:308-635-3155
Practice Address - Fax:308-635-2966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
No332S00000XSuppliersHearing Aid EquipmentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEC04198OtherPALMENTO GBA RR MEDICARE
NE=========64Medicaid
NE=========60Medicaid
NE=========13Medicaid
NE096474Medicare PIN
WYW308226Medicare PIN