Provider Demographics
NPI:1508957366
Name:DAMME, JEFFREY A (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:A
Last Name:DAMME
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:NE
Mailing Address - Zip Code:68450-2306
Mailing Address - Country:US
Mailing Address - Phone:402-335-2811
Mailing Address - Fax:402-335-2826
Practice Address - Street 1:509 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:NE
Practice Address - Zip Code:68450-2306
Practice Address - Country:US
Practice Address - Phone:402-335-2811
Practice Address - Fax:402-335-2826
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE22565207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE04208OtherBCBS
KS200606970AMedicaid
NE04208OtherBCBS
KS200606970AMedicaid