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NPI Code Detail

MEDICARE: SIDNEY W JAEGER

MEDICARE: SIDNEY W JAEGER
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
1363AM0700XMedical Physician Assistant5000NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700828415
Entity Type Code : Individual
Provider Name (Legal Business Name) : SIDNEY W JAEGER
Provider Business Mailing Address
First Line : 1103 BUFFALO BND
Second Line : PO BOX 797
City : LEXINGTON
State : NE
Zip : 68850-1528
Country : US
Telephone Number : 308-324-6386
Fax Number : 308-324-6913
Provider Business Practice Location Address
First Line : 1103 BUFFALO BND
Second Line :
City : LEXINGTON
State : NE
Zip : 68850-1528
Country : US
Telephone Number : 308-324-6386
Fax Number : 308-324-6913
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2006
Last Update Date : 02/12/2014

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Directions to “ SIDNEY W JAEGER ” Practice Location

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