Individual
DR. JUSTIN LEE MAKOVICKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
222 N 192ND ST, ELKHORN, NE 68022-5363
(402) 390-4111
(402) 390-4115
Mailing address
8005 FARNAM DR STE 305, OMAHA, NE 68114-3426
(402) 390-4111
(402) 390-4115
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
54622
AZ
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
54622
AZ
Other
Enumeration date
05/11/2016
Last updated
12/13/2023
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