Individual
DR. JASON JOHN MICKELS
Active
Individual
DR. JASON JOHN MICKELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
23524
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
093431
NE MEDICARE GROUP
NE
01
—
23524
NE MEDICAL LICENSE
NE
01
—
47053349212
NE MEDICAID
NE
01
—
999334
IA MEDICAID
IA
01
—
CJ6643
RR MEDICARE GROUP
NE
01
—
P00326801
RR MEDICARE
NE
Enumeration date
02/17/2006
Last updated
02/06/2008
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