MEDICARE: DR. JERALD EDWARD RECTOR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	39344	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	251517	OTHER	MIDLANDS CHOICE
2	01-07090	OTHER	UHC
3	03140	OTHER	BCBS

General Provider Information

NPI Number	:	1831154277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JERALD EDWARD RECTOR M.D.

Provider Business Mailing Address
First Line	:	8055 O ST
Second Line	:	SUITE 300
City	:	LINCOLN
State	:	NE
Zip	:	68510-2564
Country	:	US
Telephone Number	:	402-421-0904
Fax Number	:	402-421-0946

Provider Business Practice Location Address
First Line	:	5000 N 26TH ST
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68521-4749
Country	:	US
Telephone Number	:	402-435-5300
Fax Number	:	402-742-8405

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	06/02/2008

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Directions to “ DR. JERALD EDWARD RECTOR M.D.” Practice Location

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