MEDICARE: JASON LAU MD

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	207Q00000X	Family Medicine Physician	MD-50069	IA

General Provider Information

NPI Number	:	1932690633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON LAU MD

Provider Business Mailing Address
First Line	:	984150 NEBRASKA MEDICAL CTR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68198-4150
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 E HILLCREST AVE
Second Line	:
City	:	INDIANOLA
State	:	IA
Zip	:	50125-9027
Country	:	US
Telephone Number	:	515-961-3700
Fax Number	:

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

Provider Enumeration Date	:	05/29/2018
Last Update Date	:	12/13/2022

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Directions to “ JASON LAU MD” Practice Location

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