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Individual

JON R GOLDSMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
6829 N 72ND ST, SUITE 7500, OMAHA, NE 68122-1723
(402) 933-8540
(402) 933-8578
Mailing address
7261 MERCY RD, ATTN: CREDENTIALING, OMAHA, NE 68124-2311
(402) 398-6255

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
304
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10026225000
NE
Enumeration date
04/19/2006
Last updated
08/02/2016
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