Individual
DR. JEFFREY N HAWTHORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
450 E 23RD ST, FREMONT, NE 68025-2303
(402) 727-7990
(402) 727-1761
Mailing address
825 S. 169TH ST., 3RD FLOOR - SOUTH, OMAHA, NE 68118-4347
(402) 354-4822
(402) 354-5454
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
18558
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050054354
RAILROAD MEDICARE
NE
01
—
31769
BC/BS - NEBRASKA
NE
05
—
911765978-13
—
NE
Enumeration date
05/11/2006
Last updated
08/04/2022
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