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General NPI Number Information
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NPI Number | 1033228085
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Entity Type | Individual
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Provider Name | JEFFREY D MOTZ P.A.
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 2501 CAPEHART RD
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City | OFFUTT AFB
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State | NE
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Zip | 68113-1043
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Country | US
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Telephone | 402-827-4905
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Fax | 402-827-4975
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Provider Business Mailing Address
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Address Line | PO BOX 642117
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City | OMAHA
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State | NE
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Zip | 68164-8117
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Country | US
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Telephone | 402-717-4380
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Fax | 402-717-4290
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 548
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License Number State | NE
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