MEDICARE: JEFFREY A DYNEK P.A.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	1353	OK
2	363AM0700X	Medical Physician Assistant	1341	NE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00128663	OTHER	OK	MEDICARE RAILROAD

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1952372187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY A DYNEK P.A.

Provider Business Mailing Address
First Line	:	2000 Q STREET
Second Line	:	SUITE 5000
City	:	LINCOLN
State	:	NE
Zip	:	68503-3610
Country	:	US
Telephone Number	:	402-328-4922
Fax Number	:	402-421-0946

Provider Business Practice Location Address
First Line	:	7440 S 91ST ST
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68526-9797
Country	:	US
Telephone Number	:	402-489-6555
Fax Number	:	402-328-3770

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

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	06/03/2013

7440 SOUTH 91ST STREET
LINCOLN, NE
68526-9797

Practice Phone: 402-489-6555
Practice Fax: 402-328-3989