Healthcare Provider Details

I. General information

NPI: 1962580373
Provider Name (Legal Business Name): DR. JASON LEE ROHRS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JASON LEE ROHRS D.D.S.

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 MAIN STREET
LOUISVILLE NE
68037-0249
US

IV. Provider business mailing address

229 MAIN STREET P.O. BOX 249
LOUISVILLE NE
68037-0249
US

V. Phone/Fax

Practice location:
  • Phone: 402-234-3000
  • Fax: 402-234-3054
Mailing address:
  • Phone: 402-234-3000
  • Fax: 402-234-3054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6385
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: