Individual
JONATHAN W ROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4955 F STREET, OMAHA, NE 68106
(402) 717-2870
(402) 717-5231
Mailing address
PO BOX 4907, OMAHA, NE 68104
(800) 831-2402
(770) 666-9514
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
17631
NE
207ZC0500X
Cytopathology Physician
28682
IA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
17631
NE
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
28682
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06294
BCBS
NE
01
—
47016
BCBS
IA
Enumeration date
04/21/2006
Last updated
06/08/2010
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