Individual
JEFFREY DEAN LIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
266 CHADRON AVE, CHADRON, NE 69337-2348
(308) 747-2135
Mailing address
709 W 4TH ST, STE 2, CHADRON, NE 69337-2270
(308) 747-2135
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
19787
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00859
BLUE CROSS BLUE SHIELD
NE
01
—
13912
MIDLANDS CHOICE
—
05
—
47054313213
—
NE
05
—
7775974
—
SD
05
—
7775975
—
SD
Enumeration date
07/27/2005
Last updated
07/06/2021
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