Individual
JACOB VASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4920 S 30TH ST, OMAHA, NE 68107-1590
(402) 734-4110
(402) 734-3990
Mailing address
4920 S 30TH ST STE 103, OMAHA, NE 68107-1656
(402) 734-4110
(402) 734-3990
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36306
NE
Other
Enumeration date
05/02/2021
Last updated
09/04/2024
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