Basic Information
| Provider Information | |||||||||
| NPI: | 1699733410 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARTHUR | ||||||||
| FirstName: | JASON | ||||||||
| MiddleName: | ANDREW | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14301 FNB PKWY STE 100 | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681547200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4027585233 | ||||||||
| FaxNumber: | 8889721672 | ||||||||
| Practice Location | |||||||||
| Address1: | 14301 FNB PKWY STE 100 | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681547200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4027585233 | ||||||||
| FaxNumber: | 8889721672 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2006 | ||||||||
| LastUpdateDate: | 04/01/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 21522 | NE | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 10025186700 | 05 | NE | MEDICAID | 04192 | 01 | NE | BC/BS OF NEBRASKA | OTHER | 1602925 | 01 | NE | SHARE ADVANTAGE | OTHER | 0585794 | 05 | IA | MEDICAID | 236692 | 01 | NE | MIDLANDS CHOICE | OTHER | 605082700 | 01 | NE | US DEPARTMENT OF LABOR | OTHER |