Individual
JACOB SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4055 YANKEE HILL RD, LINCOLN, NE 68516-7718
(402) 328-6300
(402) 328-6311
Mailing address
4055 YANKEE HILL RD, LINCOLN, NE 68516-7718
(402) 328-6300
(402) 328-6311
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36501
NE
390200000X
Student in an Organized Health Care Education/Training Program
125.078755
IL
Other
Enumeration date
06/10/2021
Last updated
07/22/2024
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