Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 28477 | NE |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 0116021453 | VA |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 28477 | NE |
NPI | 1699909119 |
---|---|
Provider Name | Jason Phillip Weber |
First Address | Lincoln, NE 68510-4120 |
Second Address | Lincoln, NE 68510-4120 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2009 |
Last Update Date | 01/03/2016 |