Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 8350 | KY |
N | 213EG0000X | General Practice | 8350 | KY |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 6026 | NE |
N | 1223S0112X | Oral and Maxillofacial Surgeon | 778 | KY |
N | 204E00000X | Oral & Maxillofacial Surgeon | 24020 | OK |
NPI | 1316904451 |
---|---|
Provider Name | Dr. Jon Daniel Stineman |
First Address | Norfolk, NE 68701-4537 |
Second Address | Norfolk, NE 68701-4537 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 07/04/2017 |