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General NPI Number Information
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NPI Number | 1871555649
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Entity Type | Individual
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Provider Name | JONATHAN ANDREW JAKSHA MD
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Gender | Male
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 17310 WRIGHT ST STE 103
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City | OMAHA
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State | NE
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Zip | 68130-2405
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Country | US
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Telephone | 833-228-6889
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Fax | 877-853-0376
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Provider Business Mailing Address
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Address Line | 1010 N 102ND ST STE 201
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City | OMAHA
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State | NE
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Zip | 68114-2122
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Country | US
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Telephone | 833-228-6889
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Fax | 877-853-0376
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A92436
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 2005020838
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MC-165
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License Number State | GU
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 15107
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License Number State | ND
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Taxonomy #5
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | M9395
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License Number State | ID
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Taxonomy #6
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD00045333
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License Number State | WA
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Taxonomy #7
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 9680A
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License Number State | WY
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Taxonomy #8
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | W1532
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License Number State | TX
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