Basic Information
| Provider Information | |||||||||
| NPI: | 1922068089 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LANGENFELD | ||||||||
| FirstName: | JASON | ||||||||
| MiddleName: | GERARD | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 981150 NEBRASKA MEDICAL CTR | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681981150 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4025595413 | ||||||||
| FaxNumber: | 4025599659 | ||||||||
| Practice Location | |||||||||
| Address1: | 987400 NEBRASKA MEDICAL CTR | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 68198 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4025596637 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2006 | ||||||||
| LastUpdateDate: | 08/28/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | L804289 | MI | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 25051 | NE | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.