Healthcare Provider Details

I. General information

NPI: 1295627297
Provider Name (Legal Business Name): CURTIS CAWTHON JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2025
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7704 S 41ST ST
BELLEVUE NE
68147-1748
US

IV. Provider business mailing address

3107 NICHOLAS ST
OMAHA NE
68131-1468
US

V. Phone/Fax

Practice location:
  • Phone: 402-594-8226
  • Fax:
Mailing address:
  • Phone: 402-706-6430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: