Healthcare Provider Details

I. General information

NPI: 1851216287
Provider Name (Legal Business Name): AJAK JOSEPH JOK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 W TODD CIR
LINCOLN NE
68528-1781
US

IV. Provider business mailing address

410 W TODD CIR
LINCOLN NE
68528-1781
US

V. Phone/Fax

Practice location:
  • Phone: 531-310-1359
  • Fax:
Mailing address:
  • Phone: 531-310-1359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: