Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 25610 | NE |
N | 207RI0200X | Infectious Disease | 26768 | IA |
N | 207RI0200X | Infectious Disease | 42829 | WI |
NPI | 1013911692 |
---|---|
Provider Name | Jeffrey S Sartin |
First Address | Omaha, NE 68103-0755 |
Second Address | Omaha, NE 68114-3732 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2005 |
Last Update Date | 01/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013911692 | (05) | IA |
47068731712 | (05) | NE |
47068731742 | (05) | NE |
47081309213 | (05) | NE |
98798003 | (02) | NE |
IB1183007 | (02) | IA |