MEDICARE: DR. JEFFREY P GOLD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	27878	NE

General Provider Information

NPI Number	:	1093719965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY P GOLD M.D.

Provider Business Mailing Address
First Line	:	986605 NEBRASKA MEDICAL CTR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68198-6605
Country	:	US
Telephone Number	:	402-559-4200
Fax Number	:	402-559-4396

Provider Business Practice Location Address
First Line	:	986605 NEBRASKA MEDICAL CENTER
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68198-6605
Country	:	US
Telephone Number	:	402-559-4200
Fax Number	:	402-559-4396

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	08/09/2023

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