Individual
JACK G DEMOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4932 S 202ND AVE, OMAHA, NE 68135-3927
(402) 815-7500
(402) 815-7505
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-2155
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37173
NE
207Q00000X
Family Medicine Physician
R-12436
IA
Other
Enumeration date
05/23/2022
Last updated
11/24/2025
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