Individual
DR. JOEDY R ISTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7100 W CENTER RD, OMAHA, NE 68106-2714
(402) 506-9000
(402) 506-9093
Mailing address
7100 W CENTER RD, OMAHA, NE 68106-2714
(402) 506-9000
(402) 506-9093
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15531
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0949693
—
IA
05
—
10025302200
—
NE
05
—
47068731734
—
NE
05
—
47068731741
—
NE
05
—
47068731749
—
NE
05
—
47068731795
—
NE
Enumeration date
08/21/2006
Last updated
12/28/2017
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