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Individual

JASON J DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5625 S 62ND ST STE 100, LINCOLN, NE 68516-3558
(402) 489-3834
(402) 489-5049
Mailing address
5625 S 62ND ST STE 100, LINCOLN, NE 68516-3558
(402) 489-3834
(402) 489-5049

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
22519
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12 01036
UNITED HEALTHCARE
NE
01
238921
MIDLANDS CHOICE
NE
01
31574
BLUE CROSS BLUE SHIELD
NE
05
47049487112
NE
Enumeration date
06/29/2006
Last updated
04/15/2024
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